BREAK STONE LITHOTRIPSY CLINIC

A venture of Kolhapur Kidney Care Centre Pvt. Ltd.

Dear Mr.P. S. Sidhu

It was indeed a pleasure to talk to you after a longtime during your visit to our clinic . I have written this letter to let you know my experience with different makes of lithotripters.

 As you know we have been using you Vulcan VL-10 lithotripter for the last three and a half years. For initial two years or so we were using Vega I generator and since last fifteen months or so we having using Vega III generator. Recently had been to Saudi Arabia where I worked on a different make of lithotripter. This gave me a good opportunity to compare the performance of your machine with a more sophisticated lithotripter. I would like to share my experience with you through this letter.

In September 1996, I went to Saudi Arabia to work as consultant urologist at King Farhad Hospital, Hofuf, Saudi Arabia and worked with all specialists including super-specialties except cardiothoracic surgery. We had forty bedded Urology Unit with three consultant urologists. The unit also was recognized for specialty training for post-graduate in urology and General Surgery. This was supported by a big and busy Nephrology Unit with about 25 Haemodialysis machines working in two shifts. You may be aware that Middle East has lot of stone disease in its population. We had a 'Dornier Triptor 50' Lithotripsy machine in our department. This machine is one of the most sophisticated machines marked by Dornier in Europe and Middle East and as far as my knowledge goes, it has not been introduced in India. The price paid by the hospital was staggering million Saudi Riyals! (1 Riyal=10 Rupees) This machine had tremendous ease of operation because of totally remote-controlled automatic focusing, automatic inflation of bag of fluid, adjustments for pressure of bag according to patient's size, dedicated C-arm, inbuilt Ultrasound localization, computerized storage of patient data and multiple images etc. In initial stages I was really thrilled to work on this type of machine. But when I did more and more cases on the machine, my opinion changed to a great extent. We were doing about 30 patients per month between over selves. Through the fragmentation rate was acceptable compare to international standards, more than 50 patients needed strong Narcotic Analgesia. The fragments were fairly large causing severe renal Colic in many patients. Hence the ancillary procedures like D. J. stenting needed to be done in many patients including all patients with stone sizes more than 2cm. My experience with your machine has been totally different particularly since we started using Vega III generator. We hardly give any sort of analgesia to the patients as the treatment is almost painless. We have also treated on your machine children between the ages of 10-12 without any analgesia. This was never possible with Dornier Triptor 50. Post ESWL, renal colic is very rare with your machine as the fragments are very small and pass easily most of the time with almost no discomfort. Hence our rate of D. J. stenting is minimal as we stent only when the stone size is 3cm or more. The fragmentation rate is excellent with your machine and is as good as most of the so called sophisticated standard lithotripter in the international market. Though you machine lacks sophisticated gadgets as in Dornier Triptor 50, I think, the performance definitely better and that too at a very low price as compared to that machine. In India what we need is better performances at minimal burden of expenses to the patient.

I take this opportunity to congratulate you and Dr. S. Sidhu for producing an excellent lithotripter suitable for Indian conditions. I gather that you have manufactured a new shock-wave generator. I am sure it would give even better performance than Vega III generator. I wish you best of luck in marketing your machine with new generator.

We all at Break-Stone Lithotripter Clinic are fine and the machine is performing well.

Hoping to see you and Dr. S. Sidhu soon

Yours Sincerely

Dr. U. P. Bhadre