The procedure for larger Kidney Stones is undoubtedly complicated, but it is one of the most efficient ways to treat larger Kidney Stones. The highly specialized procedure is called a tubeless mini percutaneous nephrolithotomy (mini PCNL). This is a minimally invasive surgery that lets doctors remove kidney stones with the help of certain small incisions and this helps the patients with quicker than ever and smoother healing, especially compared to the treatments that were utilized in the history. Get the Best Urology Treatment In Siliguri now!
What is Mini-PCNL and how is it different from traditional PCNL?
Mini-PCNL is a minimally invasive surgical procedure used for kidney stone removal, differing from traditional PCNL its smaller sheath size, typically 14 to 20 F, compared to 24 to 30 F for standard PCNL, resulting in less blood loss, shorter hospitalization, and equal efficacy rate.
How is the procedure performed?
The mini-PCNL procedure is performed through a small incision, typically 1cm, under anesthesia, where a miniaturized nephroscope is inserted through the skin to visualize the kidney stone, and then fragmented and removed through a small sheath.
What type of anesthesia is used for Mini-PCNL?
Mini-PCNL is typically performed under general anesthesia, although regional epidural or spinal anesthesia can also be used, depending on the patient and the surgeon’s preference.
What are the potential risks and complications associated with Mini-PCNL?
The potential risks and complications of Mini-PCNL include bleeding, urinary tract infection, urine leakage from the nephrostomy site, injury to surrounding organs, sepsis, pyelonephritis, and systemic inflammatory response syndrome.
Who is a good candidate for Mini-PCNL?
A good candidate for Mini-PCNL is someone who has a large kidney stone (generally > 2 cm), multiple large stones, or stones resistant to prior treatment, and is unable to pass the stone on their own.
What size and location of kidney stones are best treated with Mini-PCNL?
Mini-PCNL is best suited for treating kidney stones that are larger than 20 mm, stones between 2-3 cm, or multiple large that are resistant to prior treatment, located in kidney or upper ureter.
Are there any medical conditions that would make me ineligible for Mini-PCNL?
Medical conditions such as severe kidney failure, bleeding disorders, or certain heart conditions may make you ineligible for Mini-PCNL. Additionally, individuals with severe kidney damage or those who have undergone other kidney stone removal procedures may not be suitable candidates for Mini-PCNL.
What is the recovery process like after Mini-PCNL?
After Mini-PCNL, you can expect to recover within two to four weeks, during which time you should avoid heavy lifting, strenuous exercise, and take antibiotics to prevent infection. You may need to stay in the hospital for one to two nights, and can return to work within one to two weeks.
How long will I need to stay in the hospital?
The length of hospital stay varies depending on the procedure and individual circumstances, but on average, you can expect to stay in the hospital for 24 to 48 hours after an uncomplicated procedure, and up to several days or even weeks for more complex cases.
What are the restrictions on my activity after the procedure?
After surgery, you should avoid strenuous activities, heavy lifting, and contact sports for 2-4 weeks. Light housekeeping and meal preparation are okay, but excessive exercise, jogging, tennis, and weightlifting should be avoided. You may need to wait 4-6 weeks before resuming normal activities, depending on your procedure and doctor’s advice.
When can I return to work or normal activities?
You can typically resume normal activities within 1-4 weeks after surgery, and strenuous activities like swimming or heavy lifting may take 8 weeks. The exact timeline depends on your procedure, health, and doctor’s advice.
What are the success rates of Mini-PCNL?
The success rates of Mini-PCNL vary from 76% to 100%, with some studies reporting stone-free rates of 83.9% for patients with stone sizes >2 cm and 100% for patients with stones <2 cm.
According to Ferakis, Nikolaos, and Stavropoulos, Marios’ 2015 study ‘Mini percutaneous nephrolithotomy in the treatment of renal and upper ureteral stones: Lessons learned from a review of the literature’, minicutaneous nephrolithotomy (miniPCNL) is a safe and effective treatment option for patients with kidney stones, offering comparable stone-free rates to conventional PCNL, with the advantage of less blood loss and shorter hospital stay.
According to Khadgi, Sanjay, et al’s 2021 study ‘Tubeless mini-percutaneous nephrolithotomy for renal stones larger than 20 mm’, mini-percutaneous nephrolithotomy (mini-PCNL) is an effective and safe treatment option patients with large renal stones (>20 mm), with a stone-free rate of 87.6% and a complication rate of 8.4%.
According to a 2021 paper published in Transl Androl Urol by a team of researchers, mini-percutaneous nephrolithotomy (mini-PCNL) is a safe and effective procedure for the treatment of renal lithiasis in pelvic ectopic kidney, with a rate of 100% compared to 50% for retrograde intrarenal surgery (RIRS), although RIRS is less time-consuming and invasive.
Are there any long-term side effects of Mini-PCNL?
Common complications of Mini-PCNL include urinary tract infection, urine leakage from the nephrostomy site, and transient fever. Postoperative pain, blood in the urine, blood clots, infection, and healing problems are also possible. Long-term effects may include deterioration of renal, especially in patients with preoperative UTI diabetes.
What is the risk of stone recurrence after Mini-PCNL?
The lifetime recurrence rate of renal stones is between 10% and 75%. More than 30% of percutaneous nephrolithotomy (PCNL) patients will experience a stone recurrence over 20-year period. The risk of stone recurrence is high, with some studies demonstrating a recurrence rate of over 50% after PCNL.
What are the alternative treatments for large kidney stones?
Alternative treatments for large kidney stones include natural remedies such as staying hydrated, increasing citric acid intake, limiting foods high in oxalates, and using apple cider vinegar, which contains acetic acid that helps dissolve kidney stones. Other remedies include drinking sugar-free lemon juice, taking magnesium citrate, and using omega-3 fatty acids.
