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Dr. Daniel Reznicek explains how extracorporeal shock wave lithotripsy works and what to expect from surgery. https://pacificnorthwesturology.com/e... ESWL is an acronym for extracorporeal shockwave lithotripsy. ESWL is a non-invasive surgical procedure, that is performed under sedation or general anesthesia to treat kidney stones. Shockwaves are created outside the body and then focused onto a stone. The stone then fragments into smaller pieces for the patient to pass on their own. The procedure is an outpatient procedure and usually lasts less than an hour. ESWL cannot be performed on all stones and has some restrictions. It cannot be used during pregnancy, on people with blood thinners, or on patients with kidney tumors. It does not work well on very dense or very large stones. The stones also have to be visualized within the body to aim the shockwave and have to be tracked during the procedure with either fluoroscopy (x-ray), or with ultrasound. Some stones that are low in the urinary tract and in the pelvis may be difficult to treat because the shockwave has to be aimed around the bones. Stones not treated by ESWL are typically treated with other minimally invasive procedures such as a ureteroscopy ( • What is a Ureteroscopy? ), or a percutaneous nephrolithotomy. Open or laparascopic surgeries for kidney stones are quite rare today.