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PCNL

Percutaneous Nephrolithotomy (PCNL) is a highly effective surgical procedure offered at MASSH for the removal of large kidney stones or multiple stones. PCNL is a minimally invasive technique that involves accessing the kidney through a small incision in the back, allowing for direct visualization and precise removal of kidney stones.

The PCNL procedure is performed under general anesthesia to ensure patient comfort. After administering anesthesia, the surgeon makes a small incision in the patient's back, strategically placed in the flank area to provide optimal access to the kidney while minimizing the risk to surrounding organs.

Once the access is established, a nephrostomy tract, a hollow tube, is inserted through the incision and into the kidney. This enables the surgeon to access the kidney and perform the stone removal procedure. A nephroscope, equipped with a camera and light source, is then passed through the nephrostomy tract, providing a clear view of the kidney and stones. Using the nephroscope, the surgeon identifies the stones within the kidney and employs various techniques to remove them. These techniques may include the fragmentation of larger stones using ultrasound or laser energy, suctioning out smaller stones, or using specialized tools to grasp and remove the stones. The choice of technique depends on factors such as the size, location, and composition of the stones. After the stones are completely removed or reduced to small fragments, a catheter or tube may be placed through the nephrostomy tract to facilitate urine drainage and removal of any remaining stone fragments. The catheter is usually removed within a few days, once the kidney has recovered.

PCNL offers several advantages for the treatment of kidney stones. It allows for the removal of larger stones or multiple stones in a single procedure, reducing the need for multiple surgeries. The direct visualization provided by the nephroscope ensures precise targeting of the stones, enhancing the effectiveness of stone removal. PCNL also has a high success rate in achieving complete stone clearance.

At MASSH, we understand that undergoing surgery is a significant decision, and we prioritize personalized care. Our experienced team will thoroughly explain the PCNL procedure, discuss expected outcomes, and address any concerns or questions you may have. We are dedicated to providing exceptional care and support throughout your treatment journey.

If you have large kidney stones or multiple stones and are considering PCNL as a treatment option, we invite you to schedule a consultation at MASSH. Our knowledgeable team will evaluate your condition and work with you to develop an individualized treatment plan. Experience the benefits of PCNL at MASSH, where we strive to provide effective kidney stone removal with minimal invasiveness and a swift recovery

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Dr. Ankit Goel

Urologist, Andrologist
Head of Department - Urology, Andrology & Uro-Oncology

Dr. Ankit Goel is a highly skilled and dedicated Consultant Urologist with a compassionate personality and more than 15 years of experience in the field of Urology. He is known for his expertise in various urological procedures, including Laparoscopic Urology, Laser Urology, Endo-Urology, Onco-Urology, and Reconstructive Urology. With his advanced surgical skills and knowledge, he delivers optimal outcomes for patients requiring urological interventions. With his comprehensive training and experience, Dr. Ankit Goel is well-versed in handling both Upper Tract and Lower Tract Endoscopic Surgeries. He has developed a special interest in Laparoscopic Urology, Uro oncology, and Reconstructive Urology. Dr. Goel's dedication to his field is evident through his active participation in live Laparoscopic workshops, where he has collaborated with renowned National and International Urologists.

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Frequently Asked Questions

Percutaneous Nephrolithotomy (PCNL) is a minimally invasive surgical procedure used to remove large kidney stones or multiple small stones that cannot be treated with other non-surgical methods such as shock wave lithotripsy or ureteroscopy. PCNL involves making a small incision in the back and inserting a tube called a nephroscope directly into the kidney to visualise and remove the stone(s). The procedure is typically performed under general anaesthesia and may require an overnight hospital stay for observation. PCNL has a high success rate for removing kidney stones and is considered a safe and effective treatment option. However, like any surgical procedure, it does carry some risks, such as bleeding, infection, and injury to surrounding organs. Patients who are candidates for PCNL will be evaluated by a urologist to determine the best treatment option for their individual situation. It is important for patients to follow their urologist's instructions before and after the procedure to ensure a successful outcome.

Percutaneous Nephrolithotomy (PCNL) is typically recommended for patients with large, complex kidney stones that cannot be effectively treated with other methods such as Extracorporeal Shock Wave Lithotripsy (ESWL) or Ureteroscopy. The procedure is also recommended for patients with stones that are causing significant obstruction, infection, or damage to the kidney. PCNL may be recommended in cases where the stones are larger than 2 cm in size, are located in a particularly challenging part of the kidney, or are made of certain types of materials that are difficult to break down with other treatments. Additionally, patients with anatomical abnormalities or other medical conditions that make other treatments unsuitable may also be recommended for PCNL. Before recommending PCNL, your urologist will typically perform a thorough evaluation to determine the size, location, and composition of your kidney stones, as well as your overall health and medical history. Based on this information, they will make a recommendation for the most appropriate treatment option to effectively treat your kidney stones and reduce the risk of complications.

Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure used to remove large kidney stones that cannot be treated with other methods. The procedure is typically performed under general anaesthesia and involves the insertion of a small, flexible instrument called a nephroscope through a small incision made in the back. The nephroscope allows the surgeon to visualise the stone and break it into smaller pieces using ultrasound or laser energy. The small pieces are then removed through the nephroscope or through a separate incision. To perform the procedure, the patient is positioned on their stomach, and a small incision is made in the skin on their back. The surgeon then inserts a needle through the incision and into the kidney, creating a tunnel to allow the nephroscope to enter. The nephroscope is then inserted into the kidney, and the stone is located using x-ray or ultrasound guidance. The stone is broken into smaller pieces using ultrasound or laser energy, and the fragments are removed using a variety of techniques. After the procedure, a drainage tube is usually left in place to allow the kidney to heal. The patient may need to stay in the hospital for a few days to recover.

As with any surgical procedure, there are risks associated with PCNL. Some of the common risks include bleeding, infection, damage to surrounding organs, and residual stones. Bleeding can occur during or after the procedure, and in some cases, may require a blood transfusion. Infection can also occur, which may require additional treatment with antibiotics. Damage to surrounding organs, such as the lungs or bowel, can occur due to the instruments used during the procedure. Residual stones may also be left behind, which may require additional treatment. In rare cases, more serious complications may occur, such as injury to the kidney or ureter, pulmonary embolism, or even death. However, with proper pre-operative evaluation and careful technique during the procedure, the risk of these complications can be minimised. It is important for patients to discuss the potential risks and benefits of PCNL with their healthcare provider before undergoing the procedure.

The recovery time after PCNL depends on the size and location of the kidney stone, as well as the overall health of the patient. In general, patients can expect to stay in the hospital for 1-2 days after the procedure, during which time they will be monitored for any signs of complications. Pain and discomfort are common in the first few days after PCNL, and patients may also experience blood in their urine. Most patients can resume their normal activities within 2-4 weeks after the procedure, although strenuous activities should be avoided for several weeks.

The success rate of PCNL varies depending on the size and location of the kidney stone, as well as the skill and experience of the surgeon. In general, PCNL has a high success rate for removing kidney stones, with success rates ranging from 70% to 90%. However, there is a risk of recurrence, particularly if the underlying cause of the kidney stone is not addressed.

After PCNL, patients should follow a healthy lifestyle to prevent the formation of new kidney stones. This includes drinking plenty of water to stay hydrated, reducing salt and animal protein intake, and increasing the consumption of fruits and vegetables. Depending on the type of kidney stone, medications may also be prescribed to prevent further stone formation. It is important for patients to follow up with their urologist regularly to monitor their kidney function and ensure that any underlying conditions that may contribute to kidney stone formation are addressed.