Overview
Percutaneous Nephrolithotomy (PCNL) is a surgical procedure that is not very invasive and is used to remove large or complicated kidney stones directly from the kidney. Most of the time, it is recommended for stones larger than 2 centimetres, staghorn calculi, or stones that shock wave lithotripsy or ureteroscopy can't treat well. A small cut is made in the patient's back to make a direct path to the kidney. A nephroscope, a thin viewing tool, is inserted through this tract to find and remove the stones. PCNL is performed in a hospital under general anaesthesia and can completely remove large stones in a single session.
Why It's Done
When kidney stones are too large, dense, or complex to pass on their own or to be treated with less invasive methods, PCNL is performed. If you don't treat large stones, they can cause a lot of pain, infections that keep coming back, blockage of the urinary tract, and damage to the kidneys that lasts a long time. The goal of the procedure is to completely remove the stones, ease symptoms, restore urine flow, and protect kidney function.
What to Expect?
Before PCNL, patients have imaging tests, such as a CT scan or ultrasound, to determine where the stones are and how large they are. Blood and urine tests are done to check how well the kidneys are working and to rule out infection. People who have the procedure done are put under general anaesthesia. The patient lies on their stomach or side during the operation. A small cut is made in the back, and imaging is used to carefully create a path to the kidney. A nephroscope is put in, and special tools are used to break the stone into smaller pieces, usually with laser or ultrasonic energy. After that, the pieces are taken out. In some cases, a temporary nephrostomy tube or ureteral stent is placed to improve drainage. The procedure usually takes between one and three hours. Patients stay in the hospital for 1 to 2 days after surgery to be monitored.
Recovery & Outlook
Most people take one to two weeks to get better, and they slowly start doing the things they used to do. There may be some mild pain or blood in the urine for a short time. PCNL is highly successful and effectively removes large kidney stones. This greatly reduces the risk of them returning and damaging the kidneys.