PCNL
Percutaneous nephrolithotomy (PCNL) is a surgical procedure employed to eliminate kidney stones that are either too large to pass naturally or fail to respond to alternative treatments. Despite being a minimally invasive surgery with fewer complications and a quicker healing process compared to open surgery, PCNL is still considered a major surgical intervention.
At Apollo Hospitals in Jubilee Hills, Hyderabad, our skilled urologists specialise in performing this advanced procedure for patients grappling with larger kidney stones. With the expertise of our urologists and the utilisation of advanced facilities, we consistently achieve optimal outcomes for PCNL, boasting a high success rate.
When is PCNL Recommended?
Percutaneous nephrolithotomy is usually advised under the following circumstances:
What Happens During PCNL?
During most PCNL procedures, patients are positioned lying on their stomach to allow the urologist access to the kidney through the back. However, alternative positions such as lying on the back or on the back with a cushion under the flank may be used.
Under general anaesthesia administered by the anesthesiologist, patients are sedated and rendered unconscious, ensuring they are unaware and pain-free during the procedure.
Once unconscious, the urologist makes a small incision, typically around 1 cm or smaller, through which a protective sleeve is inserted into the kidney. A small video camera (nephroscope) is then introduced through the sheath to locate and remove the kidney stone. In some instances, a laser or shock-wave device (lithotripter) may be utilised to fragment the stone into smaller pieces before extraction.
Following the removal of the kidney stone, the urologist may place a drainage tube or ureteral stent to facilitate urine drainage and help in the healing process. Skin incisions may be closed with stitches afterward.
URS
Ureteroscopy or URS involves the insertion of a small, flexible scope (ureteroscope) through the urethra into the bladder and ureter to diagnose and treat various urinary tract issues, including stones. The stone can be extracted without the need for incisions.
When Is Ureteroscopy Recommended?
For stones measuring up to 2 cm, URS is a safe and efficient treatment option to explore. There is a considerable likelihood of being free from stone with a single operation. URS facilitates the removal of stone fragments without requiring them to be passed out later.
What Happens During Ureteroscopy?
RIRS
Retrograde Intrarenal Surgery or RIRS is a minimally invasive technique aimed at extracting kidney stones. This procedure involves the insertion of a fiberoptic endoscope—a type of viewing tube—through the kidney. It can be performed under general, local, or spinal anaesthesia. A urologist specialised in RIRS performs this surgery.
Apollo Hospitals in Jubilee Hills, Hyderabad, provides advanced RIRS procedures to patients suffering from kidney stones.
Indications for RIRS
What Happens During the Procedure?
Before the procedure starts, the physician administers spinal or general anaesthesia to ensure the patient’s comfort throughout. Utilising imaging tests, the urologist accurately locates the position of the stone. Subsequently, a device called a ureteroscope is employed to examine the ureteral canal. With the assistance of a camera attached to one end of the tool, the surgeon can visually inspect the interior of the body to pinpoint stones or areas of ureteral obstruction.
The surgeon may extract the stones intact using forceps or fragment them into smaller pieces using laser beams. A sophisticated holmium laser is utilised to precisely target and disintegrate or dislodge the stone without causing harm to nearby organs. Afterwards, urine is employed to expel the stone fragments from the body.
Benefits of RIRS
Retrograde intrarenal surgery (RIRS) offers several advantages for treating renal stones:
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