PCNL
Procedure Overview
PCNL (Percutaneous Nephrolithotomy) is a minimally invasive surgical technique used to remove large or complex kidney stones — including staghorn stones that fill much of the kidney's collecting system — through a small puncture in the back rather than open surgery.
A telescope and specialized instruments are passed directly into the kidney through this small tract, allowing the surgeon to fragment and remove the stone in the same session.
Who Needs It
PCNL is generally recommended for large kidney stones (typically over 2 cm), staghorn stones, or stones that haven't responded to less invasive options like ESWL or RIRS.
Preparation
Preparation includes recent imaging review, blood tests, a urine culture to rule out infection, and stopping blood-thinning medication as advised. Patients are asked to fast for several hours beforehand.
Step-by-Step Procedure
Anesthesia
General anesthesia is administered for a pain-free procedure.
15–20 minAccess Creation
A small puncture is made through the back into the kidney under imaging guidance.
20–30 minTract Dilation
The access tract is gradually widened to accommodate the surgical instruments.
15 minStone Removal
The stone is fragmented using laser or ultrasonic energy and removed through the tract.
45–90 minDrainage Tube Placement
A temporary tube may be left in place to drain urine and blood, usually removed within a day or two.
5 minBenefits
- ✓Clears large or complex stones in a single session
- ✓High stone clearance rate even for staghorn stones
- ✓Direct kidney access allows thorough fragment removal
- ✓Well-established, widely used technique
Recovery Timeline
Hospital stay is typically 2–3 days. Any drainage tube is usually removed before discharge or shortly after. Most patients return to light activity within 1–2 weeks and avoid heavy lifting for about 4 weeks.
Technology Used
Thulium Laser, Nephroscope
Cost & Insurance
- • Stone size, number and complexity
- • Length of hospital stay
- • Additional imaging or lab tests required
Related Conditions
Frequently Asked Questions
A kidney stone (renal calculus) is a hard mineral deposit that forms in the kidney from concentrated urine. Stones vary in size and type, and small ones may cause no symptoms at all. When should I consult Dr. Raju R?
Bladder stones form directly in the bladder, usually because it isn't emptying fully, unlike kidney stones which form in the kidney. When should I consult Dr. Raju R?
Classic stone pain starts suddenly in the flank or back and radiates to the groin, often in waves, with nausea and sometimes blood in the urine. When should I consult Dr. Raju R?
Stones form when urine is too concentrated with calcium, oxalate, or uric acid. Low water intake, salty or high-protein diets, obesity, and family history all raise the risk. When should I consult Dr. Raju R?
Diagnosis uses a urine test, blood test, ultrasound, and usually a CT KUB scan, the most accurate way to see stone size and location. When should I consult Dr. Raju R?