Percutaneous Nephrolithotomy (PCNL) is the surgical removal of kidney stones through a minimally invasive approach. It's often used for larger or irregularly shaped stones.
If kidney stones are too large to treat with other methods, like ureteroscopy, PCNL may be utilized. This often applies to stones that are 2cm or larger.
The kidney is accessed through a small incision made in the back. A miniature fiberoptic camera, also called a nephroscope, is used to give the doctor a view of the stone’s location. A nephrolithotomy consists of removing the stone through a tube. If the stone is broken up with high-frequency sound waves before it is removed, the procedure is called a nephrolithotripsy. This treatment is one of the most effective ways to ensure that a patient is stone-free.
The incision made for this procedure is only about one centimeter in size.
The procedure is performed in just 20 to 45 minutes.
Further imaging may be used to make sure that the fragments of the stone have cleared.
What's Next?
You may need to avoid pushing, pulling, and heavy lifting for two to four weeks, but will otherwise be able to return to work within one week, depending on your situation. If you show signs of an infection or are in pain, call us so that we can evaluate. If a follow-up is needed, imaging tests may be used to check for any remaining stones and to ensure that urine is draining correctly from the kidney.
Robotic Pyelolithotomy Alternative
Robotic pyelolithotomy may be utilized for treating kidney stones as an alternative to percutaneous nephrolithotomy or flexible ureteroscopy. This modality allows for the removal of stones without placing a tract through renal tissue, reducing potential bleeding and nephron loss. This modality is utilized for select patients for which a percutaneous approach (PCNL) is not feasible.
