PCNL Surgery - Kidney Stone Treatment

As with any other surgery, the doctors suggest some diagnostic tests before PCNL surgery. These tests help them determine the size and number of stones and rule out underlying diseases or conditions that might affect the efficacy of the procedure. Some common diagnostic tests performed before PCNL surgery include: 

• Imaging tests (X Rays, abdominal ultrasound, MRI)
• Blood urea nitrogen (BUN) test
• Blood test
• Urinalysis

PCNL Procedure

PCNL surgery is performed in the following steps: 

• The patient is sedated with general anesthesia before the surgery. This helps in keeping the patient asleep throughout the surgery. 
• Next, the surgeon makes a small incision in the flank area and then inserts a nephroscope with x-ray guidance to determine the exact location of the stone. 
• Upon locating the stone, the surgeon uses a thin needle to access the kidney’s urine-collecting system. This is done with the help of a guidewire, which permits safe access for the nephroscope. 
• When access is achieved, the surgeon proceeds to extract the stones. In some cases, the stones are removed using microforceps. However, if the stones are too large, the surgeon might use a laser to break them into smaller fragments before extracting them from the system. 
• Finally, after removing all the stones, the surgeons use contrast to confirm that no stones or fragments are left in the ureter and then place a drainage catheter. 
• In some patients, the surgeons use PCNL with DJ stenting, thin and tiny tubes that ensure that swelling does not affect the drainage of urine. They are generally kept for 10 to 14 days and then removed.