Percutaneous Nephrolithotomy A Suitable Option For Which Patients

Percutaneous nephrolithotomy, commonly known as PCNL, has been rapidly evolving since the 1990s. With continuous advancements in minimally invasive technologies and medical devices, this procedure is now widely adopted in clinical settings. It is particularly recommended for patients suffering from large kidney stones or those with a high stone burden, where removing the majority of stones in a single session is essential. In such cases, PCNL offers a highly effective solution that significantly reduces the need for multiple procedures.

Another group of patients who benefit greatly from this technique are those with severe hydronephrosis or kidney swelling. For these individuals, using a ureteroscope may be limited due to the narrow ureteral passage. In contrast, PCNL allows direct access to the kidney through a small incision, avoiding the anatomical limitations of other methods.

The procedure is typically guided by ultrasound or X-ray imaging. It begins with the insertion of a needle through the skin into the kidney to create a small access tract. This tract is then gradually dilated to about 1 centimeter in diameter, allowing the insertion of specialized instruments to break up and remove the stones.

Compared to traditional open surgery that required incisions of 20 to 30 centimeters, PCNL represents a major advancement in stone treatment. It greatly reduces physical trauma, preserves kidney function, and minimizes both emotional and physical distress for patients.

In summary, percutaneous nephrolithotomy is an ideal option for patients with large or complex kidney stones, offering a safer, less invasive, and more efficient alternative to conventional surgical methods.