PCNL

pcnl Percutaneous nephrolithotomy (PCNL) is a minimally-invasive procedure for removal of kidney stones through the back by a small puncture wound. With this technique, stones located anywhere in kidney can be removed. It is usually done under general anesthesia or spinal anesthesia.Preoperative Intravenous Urogram (IVU) is done to check the location of the stone and confirm the functioning of the kidney. Other blood tests and work up to assess fitness for operation are done preoperatively.

In this operation, a tract is made through the kidney from the skin into the the pelvicalyceal system to access  the stone. The stone is localized with the telescope and broken into small pieces with an energy source which may be pneumatic or Holmium laser.

After the operation,  tubes are kept in the tract and urine passage which are removed in 1-2 days.

Complications:

  1. Haematuria- There can be bleeding from the kidney requiring blood transfusion/intervention in upto 2% of patients
  2. Injury to colon
  3. injury to lungs
  4. Hydro-thorax/Pneumothorax
  5. Infection/sepsis
  6. Urine leak may persist from the tract