Yashoda Hospitals » Surgery Care » Percutaneous nephrolithotomy (PCNL)

PCNL Surgery for kidney stones

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What is Percutaneous Nephrolithotomy (PCNL)?

Percutaneous nephrolithotomy (PCNL) is a minimally-invasive surgery that helps in removing all types of stones from the kidney. This procedure requires a small puncture sized opening, around 1 cm, on the skin’s surface.

PCNL is suitable for removing stones larger than two cm in size in the kidney and upper ureter (a tube that drains urine to the bladder). Patients are under general or spinal anaesthesia during this procedure.

How is PCNL performed? Before, during and after.

Doctors ask the patient to stop using certain medications they are currently taking that may alter the clotting effect of the blood. It is to prevent excessive bleeding during the surgery. Surgeons may also check for any signs of urinary tract infections (UTIs).

Some common indications for this infection are burning while urinating, blood in the urine, increased urinary frequency and urgency, fever, etc. So, it is advisable to inform the doctor immediately so that they can prescribe the necessary tests and treatment before the procedure.

The patient lies face down on the abdomen, and the medical professional administers the anaesthesia to them. The surgeon will perform a cystoscopy, i.e., telescopic examination of the bladder. They send X-ray dye or carbon dioxide into the kidney.

After mapping stones with a telescope, they break the stones into small pieces that they eliminate from the body using a laser or mechanical device.

The patient may experience some effects such as pain, nausea, etc.

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Cost of the PCNL Surgery

The PCNL Surgery cost can range significantly from approximately Rs. 49,000 to Rs. 2,00,000. It depends on several factors, including the specific surgical technique, the length of the hospital stay, the severity of the condition, and the surgeon’s experience.

Description	Cost
Cost of the PCNL in India and Hyderabad	Ranges typically range from Rs. 49,000 to Rs. 2,00,000.

Surgery	Description
Number of days in the hospital	Around 2-3 days
Type Of surgery	Major
Anaesthesia Type	General
Recovery	1-2 weeks
Duration of procedure	3 to 4 hours
Surgery(Laser/Minimal invasive)	Minimally invasive

Risks and complications of the PCNL

Some risks and potential complications that are associated with PCNL (Kidney Stone Removal) are:

Bleeding: Blood loss during this procedure is generally minimal, and the risk of bleeding ranges from 2-12%, depending on the size and location of the stones.
Infection: In some cases, bacteria can grow within the kidney stones and cause an infection. Hence, urinary infections should be treated before the PCNL procedure with antibiotics to lower the risk.
Failure to Remove the Stone: There is a slight risk of this happening with PCNL.
Organ Injury: Rare. However, some organs surrounding the kidney might get injured during surgery.

Who needs a PCNL Surgery?

Medical professionals advise PCNL in the following conditions:

Patients have large kidney stones blocking the collecting system branch of their kidney.
Patients have kidney stones larger than 2 cm.
The collecting tubes of the patient’s kidney show the presence of large stones.
Other treatments are unsuccessful.

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Frequently Asked Questions

The results of this procedure are permanent. However, in some cases, new kidney stones can form. Hence, it is essential to treat the underlying reason to prevent the formation of new kidney stones.

The removal of the newly formed stones will depend on the patient’s condition and medical advice.

Even though PCNL is a minimally invasive surgery, it is considered major surgery. The patient, in most cases, will be put under general anaesthesia, which requires following the same procedure that most major surgeries require.

The recovery time for PCNL surgery varies from person to person. In most cases, if the patient is healthy in other ways, it takes up to 1 to 2 weeks for a full recovery. The patient may be required to stay at the hospital for 1-3 days after the procedure.

The PCNL procedure requires puncturing the kidney to insert the device. It means that it damages the kidneys to a certain degree. However, studies have shown that PCNL is safe, and the kidneys will regain their function fully within six months.

Many studies have shown that PCNL is a safe and effective procedure for removing large kidney stones. However, there is a risk associated with PCNL like any other procedure. They are rare, but they can cause excessive bleeding, infection etc.

PCNL can be performed as an outpatient procedure with good results. However, in most cases in India, especially if the patients need to take general anaesthesia, PCNL requires staying at the hospital for one to two days.

Because this procedure requires puncturing the kidney, creatinine levels will rise significantly in the next 48 hours in most cases. But once the patient starts to recover, they go back to normal eventually.

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