One surgery for kidney stones is called Percutaneous Nephrolithotomy (PCNL).
PCNL is a surgical procedure used to remove large or irregularly shaped kidney stones that cannot be effectively treated with other methods, such as shock wave lithotripsy or ureteroscopy. During PCNL, a surgeon makes a small incision (typically in the back) and creates a tunnel directly into the kidney. This allows the surgeon to use specialized instruments to break up and remove the kidney stones.
Here's a breakdown of the procedure:
- Incision: A small incision, usually less than one inch, is made in the patient's back.
- Tunnel Creation: A hollow needle is inserted through the incision and guided into the kidney using X-ray or ultrasound imaging. This creates a pathway to the stone.
- Stone Fragmentation: A nephroscope (a small, flexible telescope with a light and camera) is inserted through the tunnel. The surgeon uses instruments inserted through the nephroscope to break the kidney stone into smaller pieces. Techniques like laser lithotripsy, ultrasonic lithotripsy, or pneumatic lithotripsy may be employed to fragment the stone.
- Stone Removal: The fragments of the kidney stone are then removed through the tunnel.
- Drainage: A nephrostomy tube may be placed in the kidney to drain urine and promote healing. This tube is typically removed a few days after the procedure.
Benefits of PCNL:
- Effective for large or complex kidney stones
- High success rate in stone removal
- Relatively short hospital stay
Risks of PCNL:
- Bleeding
- Infection
- Damage to the kidney or surrounding organs
- Need for further procedures
It is important to note that PCNL is not the only surgical option for kidney stones. Other procedures, such as ureteroscopy and shock wave lithotripsy, may be more appropriate depending on the size, location, and composition of the kidney stones, as well as the overall health of the patient. A urologist can determine the best course of treatment based on individual circumstances.
