Minimally Invasive (PCNL) Surgeries for Kidney stone Percutaneous nephrolithotomy
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Minimally Invasive Surgeries for (PCNL) Kidney stone Percutaneous nephrolithotomy
Percutaneous Nephrolithotomy (PCNL) is a procedure to remove medium-sized or large stones from the kidney by means of a nephroscope passed into the kidney through a small puncture created in the patient's back. A nephroscope uses an ultrasonic or laser probe to break up large kidney stones and suction it out. This procedure is usually done under general anaesthesia or spinal anaesthesia.
To undergo PCNL, it is ideal for the patient to have two functioning kidneys and large sized (2 cm) stone in one of the kidneys with extrarenal pelvis with mild to moderate hydronephrosis.
The advantage of the PCNL procedure as against an open surgery is that PCNL reduces the length of hospital stay, and leaves only a small stab wound scar. Also during the post-operative period, a negligible amount of pain is felt allowing the patient to recover faster.
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How is the Percutaneous nephrolithotomy (PCNL ) Surgery performed?
While you are under the general anaesthetic the surgeon will examine your bladder with a long, thin, semi-rigid or flexible telescope and pass a small tube up to your kidney, which has the stone. This is used to pass a mixture of a coloured dye and x-ray dye to the kidney making it easier to see during the operation.
You will then be placed face down on the operating table and the consultant will make one or more small incisions into your back. This is done using special metal or balloon dilators (see diagram). This enables the consultant to pass a telescope into your kidney.
The stone or stones in the kidney are then removed either intact or in pieces after breaking them with special instruments. X-rays will be taken during and at the end of the procedure to ensure that all accessible bits of the stone have been removed from your kidney.
A telescope is passed down into the kidney so that the surgeon can see the stone.
The stone is broken up and then the pieces are removed using a special instrument.
Why is Percutaneous Nephrolithotomy (PCNL) Necessary?
You have been diagnosed as having a kidney stone (or stones) causing some, or all, of these symptoms: pain, infections, bleeding or obstruction of your kidney, which if left untreated, may lead to further symptoms or complications, such as severe infection or loss of kidney function. This operation (PCNL) is performed to remove large kidney stones using a keyhole approach. This is a major operation despite the term ‘keyhole surgery’. The procedure requires a general anaesthetic and may last 1 to 3 hours with a hospital stay from 4 to 7 days. The success rate of kidney stone clearance ranges from 75% to 100% depending on various factors.