Kidney Stones 101
The Patient's Guide To Understanding Kidney Stone Disease

Causes of Kidney Stones

Preventing Kidney Stones

Symptoms of Kidney Stone

Kidney Stone Removal

Calcium Kidney Stones

Cystine Kidney Stones

Struvite Kidney Stones

Uric Acid Kidney Stones

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PERCUTANEOUS NEPHROLITHOTOMY

When Extracorporeal Shockwave Lithotripsy isn't effective at treating kidney stones, the doctor may consider a procedure called Percutaneous Nephrolithotomy as the next available treatment option.  Percutaneous Nephrolithotomy is usually a two-step procedure that generally begins in the radiology department of the hospital.  Upon arriving in radiology, the patient will most likely be sedated and the skin of the back will be numbed.  After doing this, the radiologist will usually insert a long needle into the kidney that gives the best access to the stone that will be removed. At this point, a guide wire is then passed through the needle and directed to the ureter.  The patient is then transported to the operating room where the doctor takes over the procedure.

A small incision is then made around the guide wire that was inserted in the back.  The doctor then places a balloon over the wire, and then the balloon is then inflated.  Doctors inflate the balloon to keep the kidney tissue from bleeding during the stone removal process.   A sheath is then placed over the inflated balloon, which is eventually removed creating a  tunnel from outside the body giving the doctor direct access to the kidney.  The nephroscope is then used to visualize the stone, if it isn't too big it may be able to be extracted using a tool called a grasper.  Otherwise, the stone may need to be fragmented, and then removed 

After the procedure is complete, the doctor will use a rubber catheter called a nephrostomy tube to close the incision  The nephrostomy tube has multiple functions, it controls any bleeding that may occur at the incision site. Nephrostomy tubes also drain the kidney without the urine passing through the ureter.  The nephrostomy bag and tube is normally left in the kidney until the incision site and kidney has healed.

Youtube Video of Percutaneous Nephrolithotomy

 

 

 

 

 

 

 

 

 

 

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