Percutaneous Nephrolithotomy (PCNL) - Surgery Procedure
A Percutaneous Nephrolithotomy (PCNL) is an operation to remove stones from the kidney. It is a form of keyhole surgery so is performed through a small cut in the skin. This means you will have a small scar afterwards. The procedure is carried under general anaesthetic (you are asleep). PCNL is used for the treatment of stones in the kidney which are not suitable for other, less invasive treatments because they are too large, too hard or associated with abnormal kidneys. PCNL is a highly effective method of treating kidney stones. The success rate is between 75% and 99%
Before operation
You will be admitted to the ward on the day before or on the day of the operation, depending on your medical history. Your admitting nurse will show you the ward and organise any further tests needed. On the morning of your procedure the anaesthetic team will visit and review you. Feel free to ask them about concerns or issues you may have in regard to being anaesthetised.You will need to sign a consent form for surgery. Before you sign this, please ensure that you fully understand the procedure and its possible risks. If you have any questions or concerns, please talk to your surgical team.
How is the operation performed?
Using x-ray guidance, a radiologist (specialist in using x-rays/scanners) makes an access track down to the kidney through a small cut in the skin. A surgical telescope (nephroscope) is passed into the kidney and used to see your stone. The stone is then broken into small pieces which are removed. At the end of the procedure a drain called a nephrostomy tube is left in the kidney. The fluid which comes out is likely to be blood-stained initially and tends to clear after a day or two. PCNL usually takes 1-2 hours.
After operation
After the operation you should move your feet and wriggle your toes to help promote circulation in your legs. This will reduce the risk of blood clots forming (venous thromboembolism). You will be able to eat and drink, after surgery, as soon as you feel like it. A few days after the procedure, dye is injected into the nephrostomy tube and an x-ray taken. Provided there is no blockage, the tube is then removed. This leaves a small wound It is important to drink plenty of fluids.