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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.
For those with symptoms, pain control is usually the first measure, using medications such as nonsteroidal anti-inflammatory drugs or opioids. [7] [9] Larger calculi may be helped to pass with the medication tamsulosin [10] or may require procedures such as extracorporeal shock wave lithotripsy, ureteroscopy, or percutaneous nephrolithotomy. [2]
A nephrostomy or percutaneous nephrostomy is an artificial opening created between the kidney and the skin which allows for the urinary diversion directly from the upper part of the urinary system (renal pelvis). [2] It is an interventional radiology/surgical procedure in which the renal pelvis is punctured whilst using imaging as guidance.
Dr. Janak D. Desai is an Indian urologist (M.S.; M.Ch; FRCS) best known for developing the technique of Ultra-Mini PCNL [1] which involves kidney stone removal by a minimally invasive key-hole technique which reduces the blood loss, pain and hospitalization for a patient suffering from kidney stone.
Lithotripsy is a procedure involving the physical destruction of hardened masses like kidney stones, [1] bezoars [2] or gallstones, which may be done non-invasively. The term is derived from the Greek words meaning "breaking (or pulverizing) stones" ( litho- + τρίψω [tripso]).
Removing organs through orifices prevents some of the pain of an incision and the need for a cosmetically unappealing larger scar. Any advance which leads to a decrease in pain and scarring has the potential to boost donor numbers. [13] This operation has also taken place at the Cleveland Clinic, which first performed transvaginal Nephrectomy. [14]