Percutaneous Nephrolithotomy
Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical technique used for the removal of large or hard-to-reach kidney stones.
The procedure is performed through a small incision in the skin of the back (about 1 cm), through which a nephroscope is inserted into the kidney. With the help of specialized instruments, the stones are fragmented and removed without the need for open surgery. It is usually performed under general anesthesia and guided by radiologic or ultrasound imaging to ensure precise access and extraction of stone fragments.
Source: European Association of Urology
What is it used for?
PCNL is indicated in the following cases:
- Large kidney stones (bigger than 2 cm) that cannot be eliminated by extracorporeal shock wave lithotripsy or ureteroscopy.
- Staghorn calculi (stones shaped like “branches” inside the kidney).
- Stones in patients with anatomical abnormalities that make removal difficult with other methods.
- Patients with multiple or recurrent stones where other treatments have failed.
Main benefits
- Higher efficacy for large stones → Unlike extracorporeal shock wave lithotripsy, which may require multiple sessions, PCNL allows for complete removal in a single procedure.
- Minimally invasive → Performed through a small incision, reducing postoperative pain and recovery time.
- Shorter hospital stay → Most patients can be discharged within 24–48 hours.
- Lower recurrence rate → By enabling complete removal of the stone, it reduces the likelihood of new kidney stone formation.
- Alternative to open surgery → Avoids large incisions and reduces the risk of postoperative complications.
