Percutaneous Nephrolithotripsy (pcnl) procedure

Percutaneous nephrolithotomy is a surgical procedure that helps remove kidney stones from your body when they are unable to pass on their own. PCNL is generally performed if the kidney stones are too large or when other procedures like ureteroscopy or extracorporeal shock wave lithotripsy (ESWL) fail or are not suitable.

PCNL is a minimally invasive surgery used to remove kidney stones that are too large or complex to be treated with other non-invasive treatments . It causes minimal discomfort or pain. It relieves unpleasant symptoms of large kidney stones without complications. The patient gets back to his/her normal life without any hassles. PCNL has been able to successfully replace traditional open surgery due to its advantages such as a smaller incision, and a shorter recovery period.

Those individuals with larger kidney stones (greater than 15 mm) can benefit from this procedure. PCNL is recommended when other non-invasive treatment methods fail. Moreover, patients with a history of recurrent kidney stones will also immensely gain from this surgery. In fact, PCNL is considered the optimum choicewhen there are multiple stones in the kidney or for those who are unable to undergo other non-invasive treatments such as ESWL due to medical conditions such as obesity, pregnancy, or bleeding disorders.

As with any surgery, some diagnostic tests are to be performed before the PCNL surgery to confirm the diagnosis. This helps with several things, such as determining the size and number of kidney stones, as well as ruling out any diseases or underlying conditions that might impact the procedure and its outcomes.

Some common tests for diagnosing kidney stones include the following:

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

Your doctor will give certain instructions before the PCNL surgery . This will help you prepare well as well as remain calm throughout. Preparation involves the following:

• Inform your doctor about any allergy to anesthesia, so that you remain far from any reaction later.
• In order to prevent any complications related to anesthesia, you should also avoid eating or drinking anything for 6-8 hours right before the surgery.
• You should stop smoking tobacco or limit the usage of alcohol a few days prior to the surgery as it can impact your recovery.
• Inform your doctor of all medications you are on, so that s/he may instruct you on making necessary changes. This includes discontinuing medicines such as blood thinners before the surgery.
• Make sure you arrange someone for help on the day of the surgery and for the days of recovery.
• Last but not least, clear all your doubts beforehand. Ask all questions you have in your mind, so you do not make any mistakes in any case while preparing for the PCNL surgery .

The procedure goes as follows:

• The patient is administered general anesthesia to keep him/her sedated throughout the surgery.
• The surgeon now makes a small incision in the flank region (lower back).
• This is followed by the insertion of a nephroscope with X-ray guidance. This helps determine the stone’s exact location.
• Now that the stone is located, the surgeon accesses the kidney’s urine-collecting system with the help of a thin needle. For this, the surgeon will also use a guidewire to provide safe access for the nephroscope. 
• The stone or stones are now extracted. In case the stones are too large to be removed directly with microforceps, the surgeon might first break them into smaller fragments (percutaneous nephrolithotripsy procedure).
• Once the stones are all removed, it is confirmed that no stones remain in the ureter. 
• Now, a drainage catheter is placed.
• In some cases, stents are also used. They are thin and tiny tubes that prevent any swelling from affecting the drainage of urine. These stents are removed post 10-14 days.

Percutaneous nephrolithotomy recovery time is about 4-6 weeks when talking of full recovery. Some post-operative instructions to help you boost your recovery are:

• Make sure to avoid strenuous activities and lifting heavy objects for a few weeks.
• Take the prescribed medications as instructed without fail. It will help in managing any pain or discomfort post-surgery.
• Consume a lot of fluids as instructed by your surgeon. This will help flush out small fragments of stones naturally out of your system.
• Also, having a fiber-rich diet will help you avoid constipation and straining during bowel movements. This will help promote healing.

Do contact your doctor without any delay if you notice bleeding, intense pain, or other abnormal signs during the recovery phase. Keep him/her informed of your progress and attend all follow-up sessions. Contact a Medfin expert today to find out all about percutaneous nephrolithotomy.

PCNL or percutaneous nephrolithotomy is an advanced procedure for kidney stone removal. It can successfully help you get rid of stones that are 200mm or even bigger. The success rate of this PNL kidney stone surgery is high and complications are rare with it.

Benefits

Here’s a list of some more benefits of this minimally invasive technique:

• The surgery involves only smaller incisions.
• It leaves no visible scars after surgery completion.
• Minimal to no bleeding is yet another advantage of the PCNL
• Faster recovery in comparison to other treatment methods.
• Only a shorter hospital stay is required.
• Finally, the resumption of daily activities is made easily possible within a week. 

Risks

Like any medical procedure, PCNL (percutaneous nephrolithotomy) carries some risks, although the risks are generally low. Here are some of the potential risks associated with PCNL surgery:

• Bleeding: Bleeding is a common risk associated with PCNL surgery. While most bleeding is minor and can be managed with pressure, in rare cases, significant bleeding may require a blood transfusion or other medical intervention.
• Infection: There is a risk of infection with any surgical procedure, including PCNL.
• Damage to surrounding tissue: During the PCNL procedure, there is a risk of damage to surrounding tissue, including the kidney, ureter, and nearby blood vessels.
• Anesthesia complications: These risks include allergic reactions, breathing difficulties, and cardiovascular complications.
• Stone fragments left behind: In rare cases, some small stone fragments may be left behind after the PCNL procedure. 

Overall, while the risks associated with PCNL are generally low, it is important for patients to discuss the risks and benefits of the procedure with their healthcare provider to determine if it is the right treatment option for their individual needs.

When the stones are removed in their intact form, the PCNL procedure is termed nephrolithotomy. However, if they are first broken into fragments to be flushed out through urine, the procedure is called percutaneous nephrolithotripsy surgery .

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty tasks of finding the best hospital, the finest doctor, and the latest procedure at the lowest costs. Let us take charge while you sit back and focus on your health & recovery. Think surgery! Think Medfin!