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.
RIRS is recommended for kidney stones measuring between 8 mm and 2 cm in size.
It is suitable for stones that cannot pass naturally or with medications.
The procedure is advised when stones are not suitable for ESWL (shock wave therapy).
It is also effective for stones located in difficult-to-reach areas of the kidney.
RIRS is preferred for patients who are not fit for open or major surgery.
There is no external cut or scar as the surgery is performed naturally through the urinary passage.
The procedure causes very little pain compared to open surgery.
Recovery is quick, and patients are usually discharged within 1–2 days.
It is safe for obese, diabetic, or cardiac patients.
Laser technology precisely breaks even hard stones into dust.
The procedure involves minimal bleeding.
The patient is placed under anesthesia before starting the procedure.
A flexible ureteroscope is passed through the urethra, bladder, ureter, and into the kidney.
Stones are identified using a camera attached to the scope.
A Holmium/YAG laser is used to break stones into dust or small pieces.
Stone fragments are either removed or allowed to pass naturally through urine.
A DJ stent (temporary tube) may be placed to ensure smooth urine flow.
Hospital stay is typically between 24 and 48 hours.
If a stent is placed, it is usually removed within 1–2 weeks.
Patients can resume normal activities quickly after the procedure.
Drinking plenty of water, around 2.5–3 liters per day, is recommended.
Regular follow-up with ultrasound or CT scan may be required to ensure complete stone clearance.
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.