This is an exciting new development in salivary gland stone management.  The StoneBreaker™ Pneumatic Lithotripter is a device by Cook Medical which has been previously used to successfully fragment kidney stones.  The device has been adapted and was made much smaller to make it possible to pass it through a miniature endoscope into the salivary gland ducts.  It is then positioned directly onto the stone.  It is powered by high pressure carbon dioxide and when deployed, a shockwave passes through the stone.  This causes the stone to break into smaller fragments, thus facilitating removal by basket retrieval or passing naturally out of the gland. 

I was the first person in the world to use StoneBreaker™ to fragment a salivary gland stone in a patient and the technology is not widely available.  It is currently only offered in 2 centres worldwide, one through the salivary gland service that I provide at Guys Hospital and Kings College Hospital and a further centre in Erlangen, Germany.  As initial outcomes from the treatment have been good, it is likely that other centres will begin to offer the treatment and I am actively involved in training other Consultant Surgeons in the technique both Nationally and Internationally.