What is Percutaneous Nephrolithotomy?

Percutaneous nephrolithotomy is an inpatient invasive procedure in which the surgeon removes the kidney stone(s) through a small incision in the skin. Generally, this procedure is used to remove stones larger than 2 cm or irregularly shaped stones. This procedure is usually performed when less invasive procedures are not feasible or have failed to provide the desired outcome.

The cost of this procedure ranges from Rs.75,000 to Rs.1,10,000 depending on the clinical presentation. It is performed under general anaesthesia and takes about 2-3 hours to complete. .

How is a Percutaneous Nephrolithotomy performed?

The process of PCNL involves the following steps:

  • At the outset, the anaesthetist administers the required dosage of general anaesthesia.

  • Once the anaesthesia takes effect, the urologist inserts a cystoscope (a telescope-like instrument which is a thin tube with a camera and light on the end) to inspect the urinary bladder.

  • He inserts a tube (catheter) into the ureter to your kidney and injects a special dye through the tube which travels to the kidneys. This radio-opaque dye highlights the kidney stones on an X-ray.

  • Once the stone is located by X-ray, the urologist makes a 1.5 cm incision on your back, and through it, he accesses the kidney with an x-ray guided fine needle.

  • Finally, the urologist removes the stones through the scope using suction. Alternatively, the doctor may also use a grasper to retrieve the stone fragments from your body.

  • For multiple stones in the kidney, this procedure may be repeated through other access sites, if required, until all the stones are removed.