A scope is inserted through a small incision in your back to remove the kidney stones. With this surgery, your doctor uses a small scope, along with instruments to pluck or vacuum the stones, through a small cut in your back. It’s sometimes also called percutaneous (through-the-skin) nephrolithotomy or stone extraction.
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Large kidney stones are blocking more than one branch of the collecting system of the kidney (known as staghorn kidney stones)
Before you undergo percutaneous nephrolithotomy, your doctor will perform several tests. Urine and blood tests check for signs of infection or other problems, and a computerized tomography (CT) scan determines where the stones are in your kidney.
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Before the procedure, your surgeon may have you go to the radiology department, where a radiologist will use CT, ultrasound or X-ray imaging to guide access to the kidney. This is done with a local anesthetic, meaning you will be awake but will not feel any pain. You will then be transferred to the operating room for the actual procedure.
Alternately, your surgeon may prefer to access the kidney in the operating room while you are under general anesthesia. In this case, the surgeon will put a tube through your bladder and up into your kidney, and will use X-ray imaging to make a puncture in your kidney so that the stones can be removed. If you have very large stones, the surgeon may need to make more than one puncture.
Before the procedure, your doctor will test your urine and blood for infection. You’ll also have a CT scan, ultrasound, or X-ray so she can see exactly where the stones are.
The surgery usually lasts an hour or two. You’ll lie face-down on a surgical table. You’ll have general anesthesia, so you won’t be awake or feel any pain. Your doctor will inject your bladder with a dye or carbon dioxide so she can “map” the branches of your kidney through a scope.
Then the doctor make a small cut midway down your back on the side with the stones. after that the doctor will insert a fiber-optic camera to peer in. She’ll either remove the stones, or she’ll use a laser, ultrasonic, or mechanical device to break them up first. When your stones are crushed before removal, it’s called nephrolithotripsy.
You may leave surgery with a small stent that keeps the tube between the kidney and the bladder open to help with urine drainage. You may also have a tube coming from your incision that helps drain fluid from your kidney to a bag attached to the outside of your body. Your doctor will remove it after 1-2 weeks.
You’ll usually need to stay in the hospital for 1-2 days. You may be able to go back to work about a week after. But you’ll have to avoid heavy lifting or pulling for up to a month.
You may stay in the hospital for one or two days after the procedure. Your doctor will recommend that you avoid heavy lifting, and pushing or pulling for two to four weeks. You may be able to return to work after a week.
If the doctor has left drainage tubes in the kidney, you’ll need to watch for any bleeding.
If you develop a fever or chills, contact your doctor. These could be signs and symptoms of infection. Your doctor will probably take urine and blood tests and X-rays and then send you to the emergency department
As with most surgeries, you can have complications after your nephrolithotomy. But problems are uncommon.
Bleeding. Rarely, you might lose enough blood to require a blood transfusion.
Infection. Signs include a fever, drainage from the incision on your back, pain when you pee, or having to go to the bathroom a lot.
Tissue or organ injury. It’s uncommon, but the surgery could damage organs near the kidney, like your bowel, blood vessels, spleen, and liver.