Percutaneous nephrolithotomy (PCNL)

For kidney and ureteral stones that are too large (usually larger than 2 centimeters), too numerous, or too dense to be treated by extracorporeal shock wave lithotripsy (ESWL) or ureteroscopy, PCNL (percutaneous nephrolithotomy or stone extraction) offers a minimally invasive method of removing these stones.

Historically, large kidney and ureteral stones were removed through open surgery, requiring a large flank incision. Percutaneous nephrolithotomy is performed through a 1-cm skin incision and thus minimizes incision size, pain, blood loss, blood transfusions and shortens hospitalization. This technique also has a higher success rate for clearing all stones in one setting than other techniques such as ESWL, which often require several procedures.

What is it?

Percutaneous NephroLithotomy (PCNL) is the preferred technique for treating larger kidney stones (over 2cm in diameter) located within the kidney. It involves keyhole surgery that is performed through a 1cm incision in the skin (see diagram). A mini-PERC is similar in approach, but represents a refinement in the technique due to having smaller cameras, better stone lasers and specialized tools. The incision that is made in the skin is much smaller and allows for quicker patient recovery and results in a safer procedure.

What are the advantages?

Allows for large or complicated stones to be treated in a minimally invasive fashion, which in the past this would have necessitated a large incision, and longer hospital stay.

Hospital stay is now 2-4 days, and the out of hospital recovery time is significantly shorter than the traditional open surgical approaches.

Quicker return to work.