Urolithiasis is a major problem in the general population recently, because of its high prevalence and recurrence rate will be also high. When conventional therapies reach certain limit, Mini-PCNL treatment will be done for percutaneous removal of larger sized kidney stones (or) renal calculi up to the size of 20mm. A special mini instrument was used for Mini-PCNL.
PROCEDURE OF MINI PCNL:
The operation was done during a hospital stay of generally 4-5 days. And performed under general anaesthesia.
After contrast medium imaging to the kidney tract wo the effected side, the kidney was punctured directly from the skin in the area of the flank.
The puncture was controlled by ultrsound and fluoroscopy. After safely dilating (using a bougie) of the puncture canal, the insertion of the endoscope into the kidney was done.
Using a special laser, the kidney stones were broken down into small pieces and washed out while a direct view of the operation was provided.
In the final step of the surgery, a catheter (hose) called renal fistula, was placed into the kidney to secure the outward flow of the urine. This catheter can usually removed without any pain few days after the surgery was done.
Mini-PCNL involves a cost effective and very safe surgical treatment to treat the kidney stones. Based on the size of the stones, repeated surgery will be reqiured but it was very rare. Usually, the patient will be immediately “stone-free”. By using small instruments that makes Mini-PCNL a low-risk method. The use of disposables and consumables is minimum so the patient will recovery so fast. Hospital stay was relatively very shorter after mini-PCNL surgery. Analgesic requirement has also been significantly very low in mini-PCNL when compared with standard PCNL.
Complications can occur during and after the procedure and can be related to renal access and stone removal but mostly limited blood loss, abdomen or back pain. Severe complications like heavy bleeding are extremely rare and treatable.