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Percutaneous Nephrolithotomy (PCNL)

About PCNL for Treating Large Kidney Stones

Percutaneous nephrolithotomy (PCNL) and tubeless PCNL are innovative surgical treatments for patients who have large kidney stones that cannot be treated successfully using SWL (shock wave therapy) or other therapies. PCNL has become the standard surgical treatment for large kidney stones including staghorn stones (stones that fill the kidney).

Our Unique Approach to PCNL

Our physicians utilize a special method to gain renal access with precision, utilizing CT imaging and real time fluoroscopy mapping techniques to ensure the most accurate placement of the nephrostomy tube for the most successful removal of the kidney stone.

The placement of the nephrostomy tube is performed at the same time as the PCNL procedure and the majority of patients do not need a nephrostomy tube placed at the end of the procedure. This is known as a Tubeless PCNL.

This precise access results in:

  • The most accurate localization of the stone.
  • Minimal trauma to the kidney and surrounding tissue.
  • Complete stone removal.
  • Fewer post-operative complications, less pain and better recovery following removal of the stone.

Following the procedure, the physician takes another image of the kidney to ensure that the stone has been entirely removed and no stone fragments remain.

Benefits of PCNL

Patients typically experience less post-operative pain as compared to more invasive open surgery. There are fewer complications compared to open surgery due to small incisions used to access to the kidney. This means PCNL patients can return to their daily living activities more quickly compared to patients who have had open surgery.

Tubeless PCNL offers patients the benefits of no urine leakage, no discomfort from an external drainage tube, and many patients report quicker recovery.

Pre-Surgical Preparation

Our physicians can perform the PCNL procedure in a hospital operating suite or in one of state-of-the-art ambulatory surgery centers. The procedure is performed under general anesthesia and takes from 90 minutes to 3 hours depending on the complexity of the stone being treated.

Before surgery, our physician utilizes special CT imaging to map out the kidney and to help identify the safest and best entry point into the kidney to ensure a more complete removal of the stone(s).

You will be instructed to do the following to prepare for your surgery:

  • A few weeks prior to surgery, you will need to see your Primary Care Physician for a physical examination, blood work and possibly an EKG. Our office will provide a list of tests needed for surgical clearance.
  • Prior to surgery, have nothing to eat or drink after midnight the night prior to the procedure unless otherwise instructed.
  • You may need to stop aspirin or blood thinners depending on your physician’s instructions (never stop aspirin and blood thinners without discussing with your primary care physician).
  • Please bring a list of your current medications to your surgery.
  • You will need to arrive 90 minutes prior to the scheduled procedure.

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