Percutaneous Nephrolithotomy

PCNLPercutaneous nephrolithotomy (PCNL)

This operation is to remove medium-sized or large kidney stones and stones that have remained in the body longer than four weeks. It uses minimally invasive surgery, and involves a small incision of around 1cm through the skin.

Percutaneous nephrolithotomy (PCNL) is a keyhole surgical procedure performed under general anaesthesia or spinal anaesthesia. The kidney stones it deals with are usually more than 2 cm in size, and are broken up for removal.

For the incision to be in the right place, the stone is precisely located within your kidney by means of X-ray, scan or cystoscopy (see cystoscopy). A track to the kidney is created, wide enough to take a nephroscope – that’s a scope with several tools attached, designed to operate on the kidney.

The tools used in a percutaneous nephrolithotomy include a fibre optic light, a camera for viewing the inside of the kidney, an ultrasonic or laser ‘lithotriptor’- a probe to break up large kidney stones – a water supply and sucker to wash out small pieces of stone and a device with a basket on the end to grasp and remove small kidney stones.

A nephrostomy tube then drains urine from the kidney through the same incision, and a catheter is usually left in the bladder at the end of the procedure, until normal functions resume.

It may be necessary to make incisions at more than one site if you have several stones scattered throughout the kidney

Percutaneous nephrolithotomy usually takes about three to four hours to complete. As it is minimally invasive, it’s not as damaging as open surgery on the kidneys, and the recovery time is much faster with less opportunity for infection.

Percutaneous nephrolithotomy usually has a higher success rate of stone removal than extracorporeal shock wave lithotripsy (ESWL). Read more at Lithotripsy

Retreatment is occasionally necessary in cases involving very large stones.

Mini-Percutaneous Nephrolithotomy (MPCNL)

The latest advance in percutaneous nephrolithotomy available at Somerset Urology Associates, this keyhole surgery is performed with a miniaturized nephroscope.

Mini-Percutaneous Nephrolithotomy is 99% effective in removing smaller kidney stones. The benefits are that operating time is reduced to around one and a half hours; there are usually fewer complications; and a shorter recovery time.

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