PCNL (Percutaneous Nephrolithotomy) is typically performed with the patient under general anaesthesia. It is a minimally invasive procedure designed to remove large or complex kidney stones.

Procedure Overview:

• A small tube called a catheter is placed into the bladder to drain urine. It stays in place using a balloon.
• Another catheter is placed into the ureter. Through this, a contrast dye may be introduced to help identify the exact location of the stone using X-rays or ultrasound.
• Once the stone is located, the kidney’s collecting system is accessed using a thin needle, and a guidewire is inserted. This guidewire allows safe passage for a nephroscope, a thin, tube-like instrument used to view inside the kidney.
• The access route is gradually expanded to allow insertion of the nephroscope.
• Stones are removed in one of two ways:
  • Nephrolithotomy: Smaller stones are removed directly using a grasper.
  • Nephrolithotripsy: Larger stones are first broken into smaller pieces using a laser or other energy device before removal.
• Once all stones are cleared, contrast material is again used to confirm that no fragments remain in the kidney or ureter (the tube connecting the kidney to the bladder).
• To ensure proper drainage of urine post-surgery, a temporary small tube called a double-J (DJ) stent may be placed. It stays in place by coiling in both the kidney and bladder.
• At the end of the procedure, a drainage catheter called a nephrostomy tube may be placed to drain fluid directly from the kidney.