Percutaneous Nephrolithotomy (PCNL)/Keyhole Surgery in Delhi
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Care Well Medical Center offers the best cost of treatment for kidney stones of size above 2 cms with the help of PCNL Surgery in Delhi, India at our Care Well Medical centre situated in CR Park (South Delhi). PCNL is also known as Keyhole surgery. All surgeries are done by experienced & renowned surgeon.
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PCNL Keyhole Surgery
Percutaneous Nephrolithotomy (PCNL) is a surgical procedure for treating large kidney stones, over 2cm in diameter. The keyhole surgery is performed through a 1cm incision in the skin that overlies the kidney.
Advantages & Disadvantages of PCNL Surgery
PCNL surgery has the following advantages:
- Previously, large or complicated kidney stones were treated by making large incisions on skin. With PCNL technique, complex kidney stones can be treated in a minimally invasive manner.
- Compared to traditional open surgery, which takes quite some time for complete recovery; the recovery time after PCNL treatment, is relatively shorter.
- Patients only need to stay in hospitals for 3-4 days, depending on their physical health and condition.
Since PCNL surgery involves improved techniques and treatment procedures, therefore there aren’t any significant disadvantages. The treatment is of modern origin, safe, and most effective for treating kidney stones.
- At first, surgeons perform in-depth imaging of the patient’s kidney, to determine the position of the stone, and assess its relationship to the kidney as well as nearby structures and organs. It helps them to plan the entire treatment and get the best access points to the stones, so that they can effectively remove them, and provide relief to the patient.
- Since the process is done under general anesthesia, patients must avoid consuming any food or drink, before 6 hours of treatment.
- Patients, who are into regular medications, must have their medicines with just a sip of water. Certain medications which contain blood-thinning agents like aspirin, warfarin, clopidogrel, etc. and non-steroidal anti-inflammatory should ideally be stopped for 7-10 days, before the treatment.
- Mid-stream urine test (MSU) is essential for ensuring that sterile urine, prior to PCNL surgery. Patients also need to undergo certain other tests like urine culture, kidney function studies, and complete blood counts. Before starting the treatment, all the test reports are studied and assessed by the surgeons. It helps them to understand the existing condition of the stone, as well as the physical health of the patient.
- At the time of surgery, patients must carry all regular medications, along with their medical history file.
Post-Surgical Risks & Complications
PCNL Keyhole Surgery has low risks and complications. However, such a procedure should be done by an experienced urologist, who has received specialized training in the treatment process, and is aided by meticulous pre-operative planning. Certain after-surgery complications like excessive bleeding which necessitate 2% blood transfusion, 1% embolization, and 0.5% renal exploration; infection; and injuries in surrounding organs like bowel, spleen, lung, and liver, are uncommon.
PCNL Surgical Procedure
The surgery is done under general anesthesia. It takes about 2 to 3 hours for the complete surgery. The entire procedure is performed in the presence of a surgeon, an anesthetist, radiology and nursing staff. During the treatment, patients are made to lie down on their front stomach. The medical team takes help of the X-Ray imaging and accordingly enters a 1cm tube into the kidney. With this, they get access to the kidney drainage system, and use instruments and telescopes to properly visualize, fragment, and finally remove the stones, from its position. When this treatment comes to an end; the surgeons leave a nephrostomy tube, a drainage catheter in the kidney. This tube exits through the skin.
Expectations from PCNL Treatment
- Patients can expect to have a temporary catheter- the nephrostomy tube, which shall drain the kidney. They shall also have a urinary catheter in-situ. Both these tubes are removed, just before patients are released from the hospital.
- Bloodstained urine for a week, after discharge, is normal.
- Soon after PCNL treatment, radiologists perform imaging to ensure that stone has been cleared.
- In rare cases, patients have to undergo another minor surgery for eliminating remaining stones, if any, and achieving complete stone clearance.
- Initial follow-ups are done within 6 weeks, after discharge. Recovery period lasts up to few weeks. In this time, patients might experience slight discomfort from the wound, which is natural, and therefore they must not panic.
- Patients are provided with oral medicines, to be consumed for five days, after discharge. It helps to prevent infection and potential threats.
- While recovering, if patients feel unwell, develop fever, chills, or severe bleeding; they must report to the hospital, immediately.