Minimally Invasive Stone Surgery: Is It Harmful to the Kidneys?

Minimally invasive stone removal techniques, such as extracorporeal shock wave lithotripsy (ESWL) and endoscopic procedures, are widely used due to their effectiveness and reduced recovery times. ESWL, in particular, is known for being non-invasive, cost-effective, and associated with minimal trauma, making it a popular option even in rural hospitals. When the energy levels and treatment intervals are properly managed, the impact on kidney function is generally minimal.

Endoscopic procedures include ureteroscopic lithotripsy, flexible ureteroscopic lithotripsy, and percutaneous nephrolithotomy (PCNL). Ureteroscopic techniques access the stones through natural body pathways, resulting in limited damage to the kidneys. However, PCNL requires a puncture through the renal parenchyma to create a direct access channel to the kidney, which can cause more significant tissue disruption.

While PCNL is highly effective for large or complex kidney stones, it does carry a higher risk of complications such as bleeding. In some cases, postoperative hemorrhage may require additional interventions like angiographic embolization, which can further stress the kidney. Therefore, careful evaluation and skilled surgical technique are essential to minimize renal damage when considering minimally invasive stone treatments.