Wanted Electrohydraulic Lithotripter Equipment - Buying Leads

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Tips for buying Electrohydraulic Lithotripter

1. These units are used for locating, viewing, fragmenting, and removing urinary tract or renal calculi; they may also be used to disintegrate salivary stones or bile duct stones. Units with footswitch are recommended because they keep the operator's hands free to position the unit.
2. Different pulse energy and pulse rate portray electro-hydraulic lithotripters; pulse duration and voltage determine the amount of energy delivered per pulse. Available pulse rates vary and are often a function of the pulse duration selected.  Acceptable electrode size varies from 1.7 Fr/77 cm to 9 Fr/40 cm; the longer lengths are usually used for biliary applications.
3. Laser devices should have a wavelength of about 2,100 nm and a visible aiming beam to ensure accurate placement. Pulse duration and power determine the amount of energy delivered per pulse; available pulse rates also vary among manufacturers and are often a function of the selected pulse duration.
4. General lithotripsy and soft tissue surgical procedures can use low-watt lasers. High-watt lasers can be used for bladder stone lithotripsy, and pulse duration may be up to 500 usec.
5. A laser lithotripter should have a fiber diameter between 200 and 1,000 um and at least 3 ft long.
6. For lithotripsy in the lower pole of the kidney, usually small fiber diameters are used with flexible scopes. Lithotripsy in the bladder and ureter will generally use large fiber diameters with rigid scopes. Operators can use any standard endoscope to visualize placement of the lithotripter.
7. With nephroscopes, operators usually use a shorter lithotripter probe than the one used with ureteroscopes, with an outer diameter that is larger than the one used with ureteroscopes. Also the sheath diameter of the nephroscope is larger and the length is shorter than that of the ureteroscope.
8. Any rigid or flexible endoscope is acceptable for electromechanical lithotripters. The available sizes for probes should be between 0.8-9.6 Fr and 26.7-90 cm long, at minimum.
9. Manufacturers offer a wide range of IL devices. However, there is no one device that covers the entire range of clinical situations. The factors that affect the choice should include: location and size of the stone burden, endoscope configuration working channel caliber, and offset or end on port.
10. Video and photographic accessories such as cameras, videocassette recorders, and light sources, are also offered by suppliers at an additional cost. This can enhance imaging and educational uses of the instrument. 
11. To compare high cost alternatives and to determine the economic value of a single alternative, facilities can use a life cycle cost analysis. They can use low cycle cost analysis techniques to examine the cost-effectiveness of leasing or renting equipment versus purchasing it outright.
12. Low cycle cost analysis is most useful for comparing alternatives with different cash-flows and for revealing the total costs of equipment ownership because it examines the cash-flow impact of initial acquisition costs and operating costs over a period of time.
13. Suppliers offer facilities service contracts or service on a time-and-materials basis. Some third-party organizations may also provide this service. Facilities should carefully consider this issue.
14. Service contract customers can get routine software updates, which enhance the system's performance, free of charge from most suppliers. Facilities should keep in mind that software updates are often cumulative, which means that previous software revisions may be required in order to install and operate a new performance feature.
15. Facilities with a full-service contract ensure preventive maintenance at regular intervals, thereby avoiding the unexpected maintenance costs. Many suppliers extend system performance and uptime guarantees beyond the length of the warranty only for systems covered by a service contract.