Kidney stones are removed by various methods, depending on the nature of stones formed. The following treatments are common and effective in removing kidney stones. We provide the following Stone Removal treatments at Maheshwari Hospital:
- Urology Treatment.
- Flexible Ureteroscopy.
- Keyhole Surgery - Percutaneous Nephrolithotomy Surgery (PCNL).
- Open surgery.
Let us elaborate all the above treatments one-by-one here:
Ureteroscopy (URS): This treatment involves the use of a very small, fiber-optic instrument called an ureteroscope, which allows access to stones in the ureter or kidney. The ureteroscope allows your urologist to directly visualize the stone by progressing up the ureter via the bladder. No incisions are necessary. General anesthesia is generally used to keep the patient comfortable during the procedure.
Once the stone is seen through the ureteroscope, a small, basket-like device can be used to grasp smaller stones and remove them. If a stone is too large to remove in one piece, it can be fragmented into smaller pieces. Most commonly this is accomplished with laser energy.
Once the stone has been completely treated, the procedure is done. In many cases, the urologist may choose to place a stent within the ureter, to allow any post-operative swelling or reaction to subside.
Percutaneous nephrolithotomy (PNL): PNL is the treatment of choice for large stones located within the kidney that cannot be effectively treated with either SWL or URS. General anesthesiais usually required to perform a PNL. The main advantage of this approach compared to traditional open surgery is that only a small incision (about one centimeter) is required in theflank. The urologist then places a guide wire through the incision. The wire is inserted into the kidney under radiographic guidance and directed down the ureter. A passage is then created around the wire using dilators to provide access into the kidney.
An instrument called a nephroscope is then passed into the kidney to visualize the stone. Fragmentation can then be done using an ultrasonic probe or a laser. Because the tract allows passage of larger instruments, your urologist can suction out or grasp the stone fragments as they are produced. This results in a higher clearance of stone fragments than with SWL or URS.
Once the procedure is complete, a tube is usually left in the flank to drain the kidney for a period of time, from overnight to several days.
Open surgery: A large incision is required in order to expose the kidney or portion of ureter that is involved with the stone. The portion of kidney overlying the stone or the ureteral wall is then surgically cut and the stone removed.
At present, open surgery is used only in extremely rare situations for very complicated cases of stone disease.
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Maheshwari Hospital has experienced and competent urologists with the aim of offering advanced laparoscopic & endourology treatment as per with international standards purely by endoscopic means without open surgery. We also offer open surgery in some related critical cases.
