.jpeg)
What is
PCNL?
PCNL — Percutaneous Nephrolithotomy — is a keyhole surgery for removing large kidney stones. Percutaneous means through the skin. Nephrolithotomy means cutting a stone out of the kidney. Combined, the procedure creates a small tract (4–10 mm in diameter) directly into the kidney from the back, through which the stone is broken and removed.
There are three main variants:
Standard PCNL uses an 8–10 mm tract — best for very large stones, staghorn calculi, and the most complex anatomy. Highest clearance rate.
Mini-PCNL uses a smaller 4–6 mm tract — best for stones 1.5 to 3 cm. Lower bleeding risk, faster recovery, while still clearing big stones efficiently.
Tubeless PCNL avoids the post-op nephrostomy tube where safe — faster recovery and less post-op pain.
Best for these
stone scenarios.
Kidney stones over 2 cm
RIRS becomes inefficient above 2 cm — too many fragments to retrieve. PCNL clears them in one session.
Several stones in one kidney
PCNL can clear multiple stones through a single tract — far more efficient than repeated RIRS.
Staghorn calculi
Stones filling multiple calyces (staghorn) need PCNL — sometimes multiple tracts in a single session.
Failed ESWL or RIRS
Very dense stones (cystine, calcium oxalate monohydrate, brushite) often need PCNL.
Mini-PCNL preferred
Smaller tracts reduce bleeding risk and are preferred in children, single-kidney patients, and those on anticoagulants.
Stone + obstruction
When the kidney has a stone and an underlying obstruction (PUJ stenosis), PCNL can be combined with correction in one session.
How PCNL
actually goes.
Anaesthesia & positioning
General anaesthesia. Positioned (prone or supine) to allow safe puncture of the kidney.
Puncture
Fluoroscopy and/or ultrasound guidance. Needle into the kidney through the back, into the desired calyx.
Tract dilation
The needle tract is enlarged with progressive dilators to the required diameter (4–10 mm).
Stone fragmentation
A nephroscope is passed through the tract. Stones broken with laser or pneumatic lithotripter. Fragments removed.
Closure
Small dressing on back. Sometimes a temporary nephrostomy tube or DJ stent. No formal stitches.
Four facts
that matter.
Fellowship in mini-PCNL
VLD Fellowship in Advanced Endourology — mini-PCNL was a primary focus of training. Not every urologist offers mini-PCNL.
Supine and prone positioning
We use the position appropriate to the stone, not the position we know. Supine PCNL is faster and safer for many cases.
Tubeless protocol where safe
We avoid the post-op nephrostomy tube where appropriate — less pain, faster discharge.
Multi-tract capability
For complex staghorn stones, multiple tracts in a single session are possible — clearance rates of 90%+ even for the largest stones.
PCNL pricing
in Jaipur.
| Procedure | Starting from |
|---|---|
| Consultation | ₹ [____] |
| NCCT KUB | ₹ [____] |
| Mini-PCNL | from ₹ [____] |
| Standard PCNL | from ₹ [____] |
| Staghorn / multi-tract PCNL | from ₹ [____] |
| DJ stent removal | from ₹ [____] |
| Stone chemical analysis | Included |
PCNL is covered by all major insurers.
PCNL is a higher-cost procedure than RIRS — insurance is particularly valuable here. We handle pre-authorisation.
PCNL —
your questions.
Only a small puncture wound (4–10 mm) on the back. No formal stitched incision. Heals with minimal scar.
Mini-PCNL: 1–2 days. Standard PCNL: 2–4 days. Complex multi-tract PCNL: 3–5 days. Tubeless protocols can shorten this.
Less than you'd expect. Modern protocols control post-op pain well. Most patients are walking the next day.
Mini-PCNL for moderate stones (1.5–3 cm) — less bleeding, faster recovery. Standard PCNL for very large or complex stones — higher clearance. Choice depends on your specific case.
Off work 5–7 days for mini-PCNL, 7–10 days for standard PCNL. Heavy lifting and gym at 3–4 weeks. Stent removal at 2–4 weeks if placed.
Modern PCNL is safe. Significant bleeding is uncommon but possible (1–2%). Infection risk is lowered with appropriate antibiotics. Kidney injury is rare with experienced surgeons.
Rarely. With mini-PCNL and modern technique, transfusion rates are under 2%. We screen and prepare for this beforehand.
Yes — PCNL is covered by all major Indian health insurers with cashless TPA partners. PCNL is a higher-cost procedure than RIRS — insurance is particularly valuable.