Percutaneous Stone Surgery

minimally invasive procedure

In urology, as in many other surgical specialties, incisional surgery is being replaced by endoscopic surgery. Access into the kidney containing kidney stones is now being achieved with the use of rigid and flexible endoscopes passed through tubes placed in the kidney via a keyhole sized incision.

These advances in the treatment of stone surgery have occurred as a result of advances in x-ray imaging of the urinary tract and significant improvements in the use of rigid endoscopes and flexible fiberoptic endoscopes.

When percutaneous access to the kidney is achieved via the placement of a small tube or sheath into the kidney, stones can be removed in any of a number of ways.

They can be removed as a entire stone with the use of large graspers. They can be broken into small fragments, using electrohydraulic, laser or ultrasonic energy. Percutaneous stone surgery, which has all but replaced open stone surgery for large kidney stones, can be achieved with a minimal hospital stay of 24 to 36 hours and results in an incision no longer than the tip of your thumb.

Recovery occurs within two to three postoperative days, and the procedure offers the highest 'stone free rate' of all minimally invasive procedures for the removal of large kidney stones.

Percutaneous stone surgery is not for all people with stones. It is considered the recommended procedure for stones that are larger than 2 cm in size, stones that are of a composition too hard to break up with shockwave treatments, stones that are located in a position in the kidney, which prevents them from passing down the ureter after being fragmented by other forms of surgery.

A combined team approach to percutaneous stone surgery is employed by the urologists at the Urology Health Center. With use of the interventional radiologist, a percutaneous tube can be placed in the kidney, allowing direct access. This also allows drainage of the kidney that may be swollen from blockage, due to the stone.

After this tube has been placed, the urologist uses this tract to introduce his rigid and flexible endoscopes and identify the stone. After the stone has been identified, multiple options exist to both extract and break up the stone. At completion of the case, the tubes can be removed, and the patient is able to recover, knowing that he or she is stone free.