Percutaneous Nephrolithotomy
May 16, 2022 admin

PCNL (Percutaneous Nephrolithotomy)

Percutaneous nephrolithotomy (PCNL) is a surgical procedure to remove stones from the kidney by a small puncture through the skin.

Percutaneous means ‘through the skin’ and nephrolithotomy means ‘taking stones out of the kidney’.

Percutaneous nephrolithotomy (PCNL) is most suitable to remove stones of more than 2 cm in size and which are present near the pelvic region.

PCNL Procedure

Percutaneous stone surgery is usually used for larger stones. It is usually done under general anesthesia or spinal anesthesia.

After contrast medium imaging of the kidney tract on the effected side, the kidney is punctured directly through the skin in the area of the flank. The puncture is controlled via fluoroscopy and ultrasound.

A small hollow tube is placed directly through a patient’s back into the kidney through which larger instruments can then be used to fragment and extract the stone(s).

The surgery is performed by Urologist by making a small 1 cm incision in the patient’s flank are. A tube is placed through the incision into the kidney under x-ray guidance. Nephroscope is then passed through the tube in order to visualize the stone, break it up and remove it from the body. If necessary a lithotripter may be used to break up the stone before it can be removed.

The operation usually takes from 90 minutes to two hours.


A standard PCNL usually requires hospitalization for five to six days after the procedure.

The catheter usually stays in place for 1-2 days, depending on how quickly it takes the kidney to recover and the urine to become clearer. The nephrostomy tube will drain urine from the kidney that has been operated on, so the kidney is able to recover. This is usually removed 24-48 hours after surgery.

The urologist may order additional imaging studies (reports) to determine whether any fragments of stones are still present. These can be removed with a nephroscope if necessary. The nephrostomy tube is then removed and the incision covered with a bandage.

The patient will be given instructions for changing the bandage at home.

Patient should be able to go back to work three to four weeks after the operation.

Advantages of PCNL Procedure

  • Less post-operative pain.
  • Less blood loss.
  • Fast Recovery.
  • Shorter hospital stay.
  • higher success rate.
  • Any big size stone can be remove.
  • Earlier return to work and daily activities when compared to open stone surgery.