KIDNEY STONES: SURGICAL TREATMENT

SURGICAL TREATMENT OF KIDNEY STONES

Open surgery through the abdominal wall was necessary to remove the stone from the kidney until 20 years ago.

Today, treatment for these stones is improved, and many options do not require major open surgery and can be performed in outpatient setting.

Open surgery was necessary to remove the kidney stones until 20 years ago. This surgery required a recovery time of 4 to 6 weeks. Today, treatment for these stones is greatly improved and a few options without open surgery

Extracorporeal Shock Wave Lithotripsy [ESWL]

Picture: ESWL
Source:http://www.webmd.com/hw-popup/

This method is the most commonly used procedure for the treatment of kidney stone. In ESWL, shock travel through the skin and body tissues and then hit the stones; the stones breakdown into small particles and are easily passed the urinary tract in the urine.

Complications of ESWL may occur such as hematuria or blood in the urine for a few days after treatment; bruising and minor discomfort in the back or abdomen from the shock wave.

Percutaneous Nephrolithotomy or Nephrolithotripsy [PCNL]

Picture:Percutaneous

Nephrolithotomy
Source: http://www.tour2india4health.com/

This treatment is often used if ESWL does not work or if the stone is very large. In this procedure , the surgeon makes a tiny incision in the back and creates a tunnel directly to the kidney. Using an instrument called a nephroscope, the surgeon locates and removes the stone. For large stones, some type of energy probe such as ultrasonic may be needed to break the stone into small pieces. The patients stay in the hospital for several days and may have a small tube called a nephrostomy tube left in the kidney during the healing process.
The risks associated with PCNL:
• Bleeding may result from injury to blood vessels within the kidney or in the area of incision
• Formation of an arterio-venous fistula
• Injury to the surrounding organs, in rare cases to spleen, liver, pancreas.
• Fluid accumulation in the area around the incision.
• Retreatment is occasionally necessary in case of large stone.

Ureteroscopic Stone Removal

Ureteroscopy may be needed for mid-ureter and lower-ureter stones. No incision is made this procedure. The surgeon passes a very thin telescopic tube a small fiber-optic instrument called ureteroscope through urethra and bladder into the ureter. The surgeon locates the stone and either removes it with a cage-like device or shatters it with a special instrument that produces a form of shock wave. A small tube or stent may be left in the ureter for a few days to help urine flow.


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