Doctors for Percutaneous Nephrolithotomy in Hyderabad

Percutaneous nephrolithotomy (PCNL) is a highly specialized surgical procedure performed by expert urologists to remove large or complex kidney stones that are unresponsive to non-invasive or minimally invasive treatments. This procedure is also used to treat stones in other organs of the urinary tract, such as the ureters, bladder, or urethra. PCNL is typically recommended when the size and location of the stone make it difficult or impossible to pass naturally through the urinary tract. PCNL is a highly specialized procedure that requires the skill and expertise of a well-trained urologist to ensure a successful outcome. The procedure requires a small incision in the back for easy access to the kidney. A hollow needle is then inserted through the incision and into the kidney, through which a special instrument is used to break up the stone into small pieces. These pieces are then extracted through the needle or a small tube called a nephrostomy tube.

Percutaneous nephrolithotomy (PCNL) is a highly specialized surgical procedure used to remove large or complex kidney stones that are unresponsive to non-invasive or minimally invasive treatments. Below are the various types of PCNL surgery. These types include;

• Standard PCNL: Standard PCNL is the most commonly used type of PCNL and involves making a small incision in the back to access the kidney. A hollow needle is then inserted through the incision and into the kidney, through which a special instrument is used to break up the stone into small pieces. These pieces are then extracted through the needle or a small tube called a nephrostomy tube. Standard PCNL is typically done under general anesthesia and requires 1-2 days hospitalization.
• Mini-PCNL: Mini-PCNL is a minimally invasive version of the standard PCNL procedure. Due to a smaller incision in the back this procedure results in less scarring and a faster recovery time. Mini-PCNL is typically performed under local anesthesia and requires a shorter hospital stay compared to standard PCNL.
• Ultra-mini PCNL (UMP): UMP is a newer type of PCNL that uses a very small incision and specialized instruments to remove kidney stones. This procedure is similar to mini-PCNL but with an even smaller incision. UMP has been shown to have a shorter operating time and hospital stay compared to standard PCNL.
• Micro-PCNL: Micro-PCNL is the latest type of PCNL and uses a specialized instrument called a microendoscope to remove kidney stones. This procedure is the least invasive of all PCNL procedures and results in minimal scarring and a faster recovery time. Micro-PCNL is typically performed under local anesthesia and can be done on an outpatient basis.

Patients are often recommended to undergo a series of tests and procedures to ensure their eligibility for Percutaneous Nephrolithotomy (PCNL). This is to guarantee a successful surgery with lesser risk of complications. The following are the various diagnostic tests that are conducted before PCNL in Hyderabad;

• X-rays: An X-ray of the abdomen and pelvis is done to determine the size, location, and number of stones in the kidneys and urinary tract. This helps in planning the surgery and determining the type of PCNL procedure that is needed.
• Abdominal ultrasound: Employing high-frequency sound waves, this test creates digital images of the kidneys and urinary tract. This test helps surgeons identify any abnormalities, such as any obstruction or kidney damage.
• MRI: Magnetic resonance imaging (MRI) is used to obtain detailed images of the kidneys and urinary tract. It is particularly useful in identifying small stones that may be missed in other imaging tests.
• Blood tests: Blood tests are conducted to evaluate the overall health of the patient, such as their kidney function, blood count, and electrolyte levels.
• Urinalysis: In this test a sample of the patient's urine is analyzed for the presence of blood, infection, or abnormal substances. This test can detect any underlying health conditions that may interfere with the outcome of the surgery.

PCNL is performed under general anesthesia to remove large or complex kidney stones. The procedure can take anywhere from 1-2 hours to complete and is typically performed on an outpatient basis, with patients being discharged from the hospital within a day or two. The procedure is done in the following steps;

• Positioning: The patient is positioned on their stomach on the operating table and the affected kidney is exposed using fluoroscopy (real-time X-ray imaging).
• Access: After making a small incision in the back, the surgeon inserts a special needle through the skin and guides it into the kidney using fluoroscopy.
• Dilatation: A series of dilators of increasing size are passed over the needle to enlarge the tract and create a tunnel to the kidney.
• Nephroscope insertion: A nephroscope (a special instrument with a camera and light source) is passed through the tract and into the kidney to visualize the stone.
• Stone removal: Using specialized instruments, the stone is broken down into smaller pieces and removed through the nephroscope.
• Drainage: A tube (nephrostomy tube) may be left in place to drain the kidney for a short period of time after the procedure.
• Closure: Once the procedure is done the surgical incision is closed with the help of sutures or staples, and a dressing is applied after that.

Due to its minimally invasive approach and faster recovery, Percutaneous nephrolithotomy (PCNL) has become increasingly popular in the past few years. Here, we will discuss the various benefits of PCNL in Hyderabad;

• High Success Rate: PCNL has a high success rate in treating large and complex kidney stones. The procedure is effective in removing stones of all sizes, shapes, and locations within the kidney.
• Minimally Invasive: PCNL is a less invasive surgical procedure and is done by making only a small surgical cut in the back. Compared to traditional open surgery, PCNL offers a shorter hospital stay, very little pain, and a faster recovery time.
• Reduced Risk of Complications: PCNL has a lower risk of complications in comparison to open surgery. This is because the procedure is performed using specialized instruments that allow the surgeon to precisely target and remove the kidney stone without damaging surrounding tissue.
• Quick Recovery: Recovery time after PCNL is relatively quick, and most patients usually return to their normal activities in just 1-2 weeks following the procedure.
• Improved Quality of Life: By removing kidney stones, PCNL can improve a patient's quality of life by reducing pain, improving kidney function, and preventing further stone formation.

Percutaneous nephrolithotomy (PCNL) is generally considered a safe procedure, however it sometimes has general side-effects associated with surgical procedures. Below are the most common side-effects associated with PCNL;

• Bleeding: Since PCNL involves creating an incision in the back to gain access to the kidney, some bleeding may occur during or after the procedure. In most cases, this bleeding can be controlled without additional surgery. However, in rare cases, additional surgery may be needed to control the bleeding.
• Infection: PCNL is done by making a small surgical cut which can get infected if not cared for properly. To reduce this risk, patients are typically given antibiotics both pre and post surgery. Symptoms of infection may include chills, high fever, and increased pain or tenderness at the surgical site.
• Damage to surrounding tissue: In rare cases, PCNL can cause damage to surrounding tissue or organs, such as the lungs or spleen. This is more likely to occur in patients who have had previous abdominal or pelvic surgery.
• Pain and discomfort: It is common for patients to experience pain or discomfort at the surgical site following PCNL. This is often managed with over-the-counter pain killers and typically improves within a few days.
• Urinary tract issues: Some patients may experience urinary tract issues following PCNL, such as difficulty urinating or incontinence. These issues are usually temporary and resolve on their own within a few weeks.
• Allergic reactions: In rare cases, patients may have an allergic reaction to the anesthesia or medications used during the procedure. Signs of an allergic reaction may include rash, hives, difficulty breathing, or swelling of the face or throat. Such symptoms require immediate medical help.

In order to ensure a full and speedy recovery after PCNL operation, patients should follow their doctor's instructions closely. Recovery time varies, but most patients mostly resume their normal activities within 1 to 2 weeks after the procedure. Here are the recommended steps patients should take to recover after PCNL surgery;

• Pain Management: Pain is a common side effect after PCNL surgery. Pain medications may be prescribed to manage discomfort, which are to be taken as per recommended doses and schedules. Patients can also apply ice packs to the affected area to reduce swelling and alleviate pain.
• Rest and Activity: After the surgery, patients are usually advised to rest and limit their physical activity for a few days. However, they should increase their activity levels with time to prevent stiffness and promote healing. Patients may be advised to engage in light physical activity, such as walking, and avoid strenuous activities, such as heavy lifting or intense exercise, for a few weeks.
• Diet and Hydration: A healthy and balanced diet can aid in the recovery process. Patients are usually advised to drink plenty of fluids, including water, to prevent dehydration and facilitate the passage of any remaining stone fragments. Foods that are high in fiber, such as fruits, vegetables, and whole grains, can also help regulate bowel movements and prevent constipation, which is a common side effect of pain medications.
• Wound Care: Proper wound care is essential to prevent infection and promote healing. Patients may need to change dressings or apply antibiotic ointments to the surgical site as directed. It is important to keep the incision site clean and dry and avoid soaking in water, such as baths or swimming pools, until the wound has fully healed.
• Follow-up Care: Schedule follow checkups are important to monitor healing progress and prevent any potential complications. Regular consultations with the urologist can help evaluate the condition of the surgical site and monitor stone clearance. Always follow all instructions and attend all scheduled appointments to ensure a smooth recovery.