PCNL (Percutaneous Nephrolithotomy) is a minimally invasive surgery used to remove large or complex kidney stones directly through a small incision in the back.
“Percutaneous” = through the skin
“Nephro” = kidney
“Lithotomy” = removing stones
It is usually chosen when the stone is too large (>2 cm), very hard, or when other treatments like ESWL or RIRS may not be effective.
PCNL is recommended for kidney stones larger than 2 cm.
It is advised for staghorn stones that fill large parts of the kidney.
This procedure is used when stones are resistant to other treatments like laser or shockwave therapy.
It is also suitable for stones causing repeated infections or urinary blockages.
PCNL is recommended when multiple stones are present in the kidney.
The patient is given general or spinal anesthesia before the procedure.
A small incision of about 1 cm is made on the patient’s back.
A nephroscope, which is a thin tube with a camera, is inserted into the kidney.
The stone is then broken using ultrasonic, pneumatic, or laser devices.
Stone fragments are removed through the tube.
A nephrostomy tube or stent may be temporarily placed for urine drainage.
PCNL is highly effective for removing very large kidney stones.
It provides a higher stone clearance rate compared to many other methods.
The procedure is less invasive than traditional open surgery.
Hospital stay is shorter compared to open surgical procedures.
Hospital stay is usually between 2 to 4 days.
Patients typically need rest for about 1 to 2 weeks after the procedure.
Drinking plenty of fluids is advised to prevent new stone formation.
If a stent or tube is placed, it is usually removed within 1 to 2 weeks.
Follow-up imaging such as ultrasound or CT scan is done to confirm stone clearance.
Mild bleeding may occur in some cases.
There is a small risk of infection after the procedure.
In rare cases, nearby organs may be injured, although imaging guidance minimizes this risk.
M.S., M.Ch (Urology), DrNB (Urology)
Gold Medallist
VLD Fellowship in Advanced Endourology and Laparoscopy
Member:
Dr. Deepesh Kalra completed his MS in General Surgery from S.M.S medical college, Jaipur, and he did his M.Ch. in Urology from Madras Medical College, Chennai, which is one of the oldest and most prestigious institute of India. He has completed his DrNB in the field of Urology and Genitourinary surgery. He was conferred with prestigiuos H.S.Bhat Gold Medal in the field of Urology by the President Of India (Smt. Droupadi Murmu). He then went on to pursue VLD Fellowship in Advanced Endourology and Laparoscopy in hyderabad.
He has worked in Fortis memorial hospital and research center, Gurugram and Apollo hospital, Chennai.
His main areas of interest are advanced endourological procedures like RIRS, Supine PCNL and Minimal access urology.
He has multiple publications in various indexed national and international journals. He has won multiple awards in various regional and national conferences.