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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.
Bladder stones (14 mm diameter) incidentally found in a bladder diverticulum during transvesical prostatectomy (removal of the prostate via an incision in the bladder) Bladder stones are small mineral deposits that can form in the bladder. In most cases bladder stones develop when the urine becomes very concentrated or when one is dehydrated.
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.
A 2013 meta-analysis found LL can treat larger stones (> 2 cm) with good stone-free and complication rates. [ 5 ] Holmium laser lithotripsy had superior initial success and re-treatment rate compared to extracorporeal shock wave lithotripsy (ESWL) in a 2013 trial.
Risks during surgery include heart problems, pulmonary (lung) complications, development of blood clots , blocking of arteries , and injury to adjacent structures, such as bowel or vascular entities. Inadequate ureteral length may also be encountered, leading to ureteral kinking and subsequent obstruction.
Ureteroscopy is an examination of the upper urinary tract, usually performed with a ureteroscope that is passed through the urethra and the bladder, and then directly into the ureter. [1] The procedure is useful in the diagnosis and treatment of disorders such as kidney stones and urothelial carcinoma of the upper urinary tract. [1]
If a patient has a stone lodged higher in the urinary tract, the physician may use a much finer calibre scope called a ureteroscope through the bladder and up into the ureter. (The ureter is the tube that carries urine from the kidney to the bladder.)
Some of the passed fragments of a 1-cm calcium oxalate stone that was smashed using lithotripsy. The most common use of extracorporeal shockwave therapy (ESWT) is for lithotripsy to treat kidney stones [3] (urinary calculosis) and biliary calculi (stones in the gallbladder or in the liver) using an acoustic pulse.