Percutaneous Nephrolithotomy (PNL) is an endoscopic surgical technique used in the treatment of kidney stones, performed by opening a small hole in the back. This method is mostly preferred for kidney stones larger than 2 cm or so small that other treatment options (ESWL and RIRS) do not work..
How is it done?
A tunnel is formed by placing a tube about 1 cm wide from the back of the patient into the kidney. The stones inside the kidney are reached with the endoscope sent through this tunnel. These stones are removed in the same way as a whole or by being crushed by various crushers (pneumatic, ultrasonic or laser). After the intervention, if necessary, a thin plastic tube (nephrostomy tube) is placed in the kidney through the hole where the surgery was performed and left for 1-2 days for rapid recovery after the operation. It is not necessary to put this tube frequently in small stones and surgeries that end smoothly.
Are There Types of This Surgery?
PNL surgery has become possible with smaller incisions thanks to the thinner endoscopes and instruments developed in recent years. The surgery is named according to the diameter of the tube placed; While a 30 Fr (1 cm) diameter tube is placed in the standard technique, 15-18 Fr diameter tubes (5-6 mm) are used in the mini-PNL method, and 12-14 Fr diameter (3-4 mm) tubes are used in the ultramini-PNL technique. As the diameter of the tube used decreases, the possibility of some undesirable conditions such as bleeding due to surgery decreases. Again, after operations performed with smaller diameter instruments, recovery is faster, the patient feels less pain and experiences a more comfortable recovery process.
What are the advantages?
The most important advantage of this technique over other methods is that it has the highest chance of success (removal of stone) for stones larger than 2 cm. It provides a great advantage in terms of cosmetics compared to open stone surgeries performed through a large incision, which was frequently applied in the treatment of large kidney stones in the past, and provides a faster and more comfortable healing process.
Are There Risks?
Although this surgery is considered as a closed endoscopic method, it carries some risks such as bleeding, infection and neighboring organ injury. The way to minimize these risks is to make the right preparation before the surgery, to have a fully equipped equipment and to have enough experience of the surgeon in this surgery.
My PNL Experience
I have performed more than 1000 PNL operations in the last 15 years and as a result of my experience, I have been applying this surgical intervention with a success rate of over 95%. I have more than 80 scientific articles published in international journals on endoscopic stone surgeries. I have shared my experience in stone surgeries as an invited speaker in more than 100 national and international meetings and I continue to convey. You can request an appointment from the contact numbers to plan your treatment for stone disease, which is my special interest.
NOTE: The content of the page is for informational purposes only, consult your doctor for diagnosis and treatment.