Doctors for Percutaneous Nephrolithotomy in Kochi

Percutaneous nephrolithotomy (PCNL) is a procedure used to remove stones from the kidneys, as well as other organs in the urinary tract, such as the ureters, bladder, or urethra. This procedure is used to remove large or complex kidney stones that cannot be treated with other non-invasive or minimally invasive treatments.

There are different types of PCNL procedures that may be performed, depending on the size, location, and complexity of the kidney stone:

• Standard PCNL: The most typical form of percutaneous nephrolithotomy involves making a single incision in the patient's lower back and then viewing and removing the stone with the help of a nephroscope. This procedure is effective for removing large and complex stones from the kidney.
• Mini-PCNL: This is a modified version of the standard PCNL, where a smaller incision is made in the back and smaller instruments are used. Typically, instruments around 14-18 Fr. are used in this procedure. It is used for the treatment of smaller stones. In comparison to the conventional PCNL procedure, this method results in a quicker recovery period.
• Ultra-mini PCNL (UMP): This is a more minimally invasive form of PCNL, where even smaller nephroscope and instruments are used. It is mainly used for treating smaller stones in the kidney and is associated with shorter hospital stays and fewer complications. The incision size for UMP is smaller than in mini-PCNL and standard PCNL procedures.
• Micro-PCNL: This is the latest advancement in PCNL, where a micro nephroscope is used. This procedure is mainly used for treating smaller stones, and the use of the micro nephroscope is associated with a lesser risk of bleeding and tissue trauma. The micro-PCNL procedure involves a smaller incision and instruments than other types of PCNL and has the potential to further decrease the recovery time for patients.

Some diagnostic tests and evaluations are important for ensuring that PCNL surgery is safe and effective for the patient. The urologist and medical team will use the information gathered from these tests to determine the most appropriate surgical technique, anesthesia, and post-operative care for the patient. Some of these tests include:

• Medical history: The patient's medical history is reviewed to identify any previous surgeries, medical conditions, or medications that may impact the surgery or recovery process.
• Physical exam: A thorough physical examination is carried out on the patient in order to evaluate their overall health as well as the function of their kidneys. Before beginning the operation, the urologist will conduct an assessment of the patient's vital signs, which will include measuring the patient's blood pressure, heart rate, and any other essential signs that are necessary to determine the patient’s stability.
• Imaging studies: Imaging studies such as CT scans, X-rays, or ultrasounds are used to identify the size, location, and number of stones in the kidney. These details are necessary for deciding on the best surgical approach and making appropriate preparations for the operation.
• Complete Blood Count (CBC): A complete blood count (CBC) measures the number of platelets, red blood cells, and white blood cells in the patient's blood. Abnormalities in these levels may indicate an infection or bleeding disorder, which can impact the surgery or recovery process.
• Blood Chemistry Tests: During a blood chemistry test, the levels of a number of different substances in the blood, including electrolytes, glucose, and creatinine, are measured. Abnormalities in these levels may indicate kidney or liver problems, which can affect the surgery or recovery process.
• Coagulation Tests: Coagulation tests measure the blood's ability to clot, which is important for preventing excessive bleeding during the procedure. Abnormalities in these levels may indicate a bleeding disorder or a risk of excessive bleeding during the procedure.
• Urinalysis: During a urinalysis, the patient's urine is analyzed to determine whether or not it contains blood, protein, or any other substances that could point to kidney disease or an infection.
• Blood Grouping and Crossmatching: Blood grouping and crossmatching tests are done to determine the patient's blood type and to identify any antibodies that may cause a reaction during the procedure.
• Electrocardiogram (ECG): An ECG is performed to assess the patient's heart function and detect any underlying heart conditions that could increase the risk of complications during the procedure.
• Anesthesiology evaluation: An anesthesiologist evaluates the patient's suitability for general anesthesia and determines the best type of anesthesia to use based on the patient's medical history, physical exam, and other test results.

PCNL (Percutaneous nephrolithotomy) is done in the following steps:

• Anesthesia: A dose of general anesthesia is administered to the patient before the operation so that they remain unconscious and pain-free throughout the process.
• Incision: A small incision is typically made over the kidney by the surgeon in the lower back. In order to remove the kidney stone, the surgeon can now access the kidney.
• Insertion of a Nephroscope: Through the incision, a nephroscope, a lengthy, thin tube, is inserted. This device has a camera and several tools that allow the surgeon to get a good view of the stone and break it up into smaller pieces. To fragment the stone, the surgeon might make use of a laser or high-frequency sound waves produced by an ultrasound machine.
• Removal of fragments: The stone fragments are then vacuumed out of the body through the nephroscope. They could also be placed in a bag and transported to a research facility for further examination.
• Closure of the incision: When all the fragments have been removed, the incision is closed and sealed with sutures or staples. In some cases, a drainage tube will be inserted at the incision site to facilitate the drainage of any fluids or blood that may have been released.
• Recovery: Recovery time following PCNL is typically short and most patients can go home the same day or after a short hospital stay. The control of pain through medication and the administration of antibiotics are both necessary steps in the process of preventing infection. Most patients are able to resume normal activities over the course of a few weeks, although heavy lifting and strenuous exercise should be avoided for some time to allow for proper healing.

PCNL (Percutaneous Nephrolithotomy) surgery is one of the most effective treatments for kidney stones and is performed in Kochi by experienced urologists. The main benefits of PCNL surgery are:

• Highly Effective: PCNL surgery is one of the most effective treatments for kidney stones, with success rates of up to 98%. This means that most patients who undergo the procedure are able to get rid of their kidney stones quickly and effectively.
• Minimally Invasive: PCNL surgery is a minimally invasive procedure, which means that it involves making only a small incision through the skin and inserting a thin, flexible tube into the kidney to remove the stones. As a result, there is a lower chance of complications and a quicker recovery time than with other kinds of surgery.
• Painless: Most patients report minimal discomfort during and after the PCNL procedure, making it a relatively painless option for treating kidney stones. To treat any potential discomfort or pain, a doctor may prescribe painkillers.
• Quick Recovery Time: Since PCNL surgery is minimally invasive, the recovery time is much shorter compared to other types of surgery. In most cases, patients can resume their regular routines just a few days after surgery.
• Cost-Effective: PCNL surgery is a cost-effective procedure, with the cost of the procedure being much lower than other types of surgery for kidney stones. Because of this, it is an excellent choice for patients trying to find a kidney stone treatment that is also within their financial means.

These side effects may occur after the PCNL procedure:

• Pain: The PCNL procedure is associated with the most common adverse effect, which is pain. This is usually relieved by medications and other techniques. It usually occurs in the areas where the kidney was accessed or where small incisions were made.
• Bleeding: The risk of bleeding is another one that is associated with PCNL surgery. It usually stops on its own, however, if it persists, doctors may need to perform additional procedures to stop it.
• Infection: Infection is another possible side-effect of PCNL surgery. Care must be taken to keep the area around the kidney clean and to follow any instructions given by your doctor regarding taking medications and proper hygiene.
• Flank pain: Flank pain is a common side-effect of PCNL surgery as well. This is usually mild and easily remedied with medications and other treatments.
• Urinary problems: In rare cases, there may be some urinary changes after PCNL surgery. These changes may include a decreased flow of urine, a burning sensation while urinating, or urinary tract infections.
• Allergic reactions: People may experience an allergic reaction to the medications used to perform PCNL surgery. These reactions may include hives, swollen lips and tongue, breathing difficulties, or other more serious symptoms.

It can take several weeks to recover fully from a PCNL procedure, but the vast majority of patients are able to resume their normal activities within a few weeks of the procedure.

When recuperating from PCNL surgery, the following are some important considerations to keep in mind:

• Rest: After having PCNL surgery, getting plenty of rest is a vital component of the healing process.For a few weeks after surgery, rest and avoid strenuous activities.
• Diet: Eating light, healthy meals and drinking plenty of fluids is important for proper recovery after a PCNL surgery. It is important to steer clear of beverages containing alcohol and caffeine because both of these substances can cause the body to lose water.
• Medication: Taking medications as prescribed by your doctor is important for managing pain and preventing infection after a PCNL surgery. It is essential to take the medication exactly as directed, including in terms of the amount to take and how often to take it.
• Exercise: After a few days of resting, gradually starting light exercises such as walking or stretching can be helpful for promoting healing and preventing complications. Before beginning any kind of exercise routine, it is essential to get the okay from your primary care physician.
• Follow-up appointments: It's crucial to show up for all of your doctor's follow-up appointments in order to track your development and ensure that your PCNL surgery recovery is going smoothly. During these visits, your physician may remove drainage tubes or replace bandages.
• Incision site care: It is essential to practice good wound care in order to avoid getting an infection and to hasten the healing process. It is important to keep the sites clean and dry and follow your doctor's instructions for caring for the sites.