In December of 1984 the Food and Drug Administration (FDA) approved the use of Extracorporeal Shock Wave Lithotripsy (ESWLor SWL) for use in the United States. More commonly called lithotripsy, this new technology offers a noninvasive technique to eliminate kidney stones from 80% of kidney stone sufferers with a return to their normal life-style within a few days.

The lithotripter - meaning "stone crusher" in Greek, was developed after six years of research by the Dornier Systems Company, a West German aerospace company. In February 1980, the company started the first clinical trials of shock wave therapy for kidney stones.

Lithotripsy treatments today are very simple in comparison with other surgical procedures.  Though protocols vary from one facility to the next, a typical day will somewhat resemble the following:

• Arrive at the facility 1-2 hours before the scheduled time for any labs, x-rays and pre-operative medications.  Be sure to bring all necessary insurance information, and a list of your current medications and dosages.  Many facilities want you to bring your medications with you in the original containers.
• In the holding area your anesthesiologist, urologist and technician working with the urologist will come talk to you and verify the treatment site of your stone.  Please ask if you have any questions or need clarification of information given.
• Depending on the facility, some type of imaging (x-ray or ultrasound) will be used to locate the stone for targeting and treatment.  A coupling medium such as water or gel will be applied between the patient and the shockwave source.
• Once the patient is comfortable, the anesthesiologist will provide sedation medication.  Patients may hear a clapping sound produced by the lithotripter machine.  The actual treatment will last 30-45 minutes.  During this procedure it is very important to remain as still as possible.  When a patient moves, the stone moves.  Stone movement inhibits the successful targeting of the stone, resulting in less than ideal fragmentation.
• Imaging will be used at times during the entire procedure to ensure proper stone position.
• Following the procedure, you will be taken to the recovery area.  You may be in the recovery area for 1-2 hours. 
• Recovery personnel may ask you to do the following prior to discharge:
• Stand and bear your own weight
• Urinate
• Have a light snack
• Make sure you understand your discharge instructions

Since October 1985, people throughout the Midwest have had available to them this non-invasive stone treatment. A group of 13 St. Louis area hospitals joined together to form Midwest Stone Institute to operate Missouri's first lithotripter. Over 150 area urologists have access to treat their patients with this technology. Two types of lithotripters are available to the urologist to use. The Dornier lithotripter is housed at Barnes-Jewish West County Hospital, and the Storz Modulith® SLX-F2 lithotripter is transported to area hospitals for use. In addition, with the advancement of endoscopic technology, the Holmium laser is now being utilized to perform stone fragmentation with a samll laser.