Percutaneous Nephrostolithotomy (PCNL)

This procedure uses a needle passed through the skin into the kidney to either remove the stone (lithotomy) or break up the stone (lithotripsy). First, the doctor makes a small (3/8-inch) incision in the patient's back and creates a tract through the kidney to the stone.

Through the tract the doctor inserts a fiberoptic telescope called a nephroscope to either remove the stone or break it up into tiny pieces using a laser, ultrasound probe, or pneumatic device.

After the procedure, a tube is placed in the kidney (nephrostomy tube) and another tube, a stent, is positioned in the ureter to drain the kidney and allow it to heal. The doctor will remove the tubes after X-rays have shown that the kidney has healed and all the stones have been removed. X-rays will be done on the day after the procedure. If stones are still present, then PCNL will be repeated on the second post-operative day to remove any remaining fragments.

Success rates: 70-99 percent depending on stone size and location

Possible complications: Bleeding, infection, urinary injury, and adjacent organ injury.

Hospital stay and recovery: Several day hospital stay with 2-4 weeks until back to full activity.