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Lithotomy from Greek for "lithos" and "tomos" (), is a surgical method for removal of calculi, stones formed inside certain organs, such as the urinary tract (kidney stones), bladder (bladder stones), and gallbladder (), that cannot exit naturally through the urinary system or biliary tract.
Percutaneous nephrolithotomy (PCNL) is a minimally-invasive procedure to remove stones from the kidney by a small puncture wound (up to about 1 cm) through the skin. It is most suitable to remove stones of more than 2 cm in size and which are present near the pelvic region. It is usually done under general anesthesia or spinal anesthesia.
The exact area is then located by ultrasound. Local anesthetic infiltration is used to numb the area. Then a needle would pass through to make the puncture on the kidney. Then, urine from the kidney is aspirated and check for its contents. If the urine is clear, dye will be injected to delineate the renal pelvis and renal calyx. If the urine is ...
Kidney stones are primarily composed of calcium salts, with the most common being calcium oxalate (70-80%), followed by calcium phosphate and uric acid. When urine contains high concentrations of these ions, they can form crystals and eventually stones. [41] The formation of kidney stones occurs in three main phases: [41]
Prior to surgery, the bowels are typically cleared with a routine called bowel prep. [20] Bowel prep can be performed at home the 1–2 days before surgery or in some instances, occurs in a hospital before the operation. [20] Bowel prep may require magnesium citrate drink to empty the colon. [21] Bowel prep is done to reduce infection risk. [22]
A number of important medical conditions are caused by stones: [citation needed] Nephrolithiasis (kidney stones) Can cause hydronephrosis (swollen kidneys) and kidney failure; Can predispose to pyelonephritis (kidney infections) Can progress to urolithiasis; Urolithiasis (urinary bladder stones) Can progress to bladder outlet obstruction