AH-1 Stone Removal System to Treat Bladder Stones Aihua Li, Binghui Zhang，Honghai Lu, Sikuan Liu, Feng Zhang, Xiaoqiang Qian， Hui Wang and Wei Fang Department of Urology, Yangpu District Central Hospital, Shanghai 200090, China Purpose：To recommend AH-1 Stone Removal System (SRS) and introduce the structure and function to treat bladder stones. Materials: SRS is composed by illuminant and imaging component, continuous-flow component, a jaw to grab and extract stone, lithotripsy tube, handle and sheath. During surgical procedure, SRS was inserted into bladder to search stone, first stone was grabbed and fixed using jaw，then lithotripsy was performed with holmium laser or pneumatic lithotripter through lithotripsy tube. Fragments could be extracted using jaw through sheath synchronously. If there were more residual small fragments, Ellik evacuator could be connected with sheath to wash out them. The device was designed by Aihua Li, M.D. and manufactured by Hangzhou Tonglu Shikonghou Medical Instrument Co.,Ltd,China. Results: In the experiment in vitro, sphere larger than 60 mm in diameter can be fixed with jaw, sphere less than 15 mm can be grabbed directly and sphere less than 8 mm can be extracted through sheath. Inner diameter of sheath is 8.2 mm and lithotripsy tube is 1.4 mm. The jaw, like a ring in longitudinal, is located at the front of objective lens and open downward, and the central part still is a circular cavity when it is closed. The lithotripsy tube is located at the lower edge of objective lens, which facilitates fragmentation in direct vision. Two jaw pieces are frame-shaped, which is favorable to grab and fix stone. Two little bars are installed at the far end of jaw so that it can be used to extract stone fragments through sheath as a trawler and more fragments can be extracted at one time. On other hand, Ellik evacuator can be connected with sheath to wash out small fragments. The principle of swing flow is applied in design，which makes the device can collect fragments automatically. In stone fragmentation, holmium laser fiber or pneumatic lithotripter probe can be transited through lithotripsy tube to crush stone. Between January 2008 to July 2010, 37 cases of bladder stone were successfully treated by SRS. Conclusion: SRS is a novel endoscope with multiple functions to treat bladder stone. Our study shows that multiple functions such as fixing stone, crushing stone, automatically collecting stone, extracting stone, washing out stone and continuous-flow can be expected in cystolithotripsy. Especially, it can be used to automatically collect stone by swirling flow and extract more stones by jaw through sheath at one time, which can reduce stone removal time and surgical damage to urethral mucosa.