Kidney Stone Surgery and Removal

 
Non-invasive methods of kidney stone removal have have come a long way in the last three decades. And even though most people refer to any method of removing a kidney stone as "surgery," these might not be considered surgery in the traditional sense of the word. 

Surgery involving invasive techniques is rarely done nowadays. It's only done in case where other approaches have not succeeded.

Kidney stone removal or surgery should only be considered when the stone:

• hasn't passed after a reasonable time and is causing constant pain, 
• is too big to pass through the urinary tract or is lodged in a difficult place, 
• is blocking urine flow, 
• is causing ongoing urinary tract infection, 
• is damaging kidney tissue or causing constant bleeding. 

The picture to the above right shows an x-ray of a large kidney stone inside the body.

EWSL or extracorporeal shock wave lithotripsy 

ESWL is a procedure that dissolves a kidney stone and makes the remaining "grains" easier to pass through the urinary tract.

Doctors use a machine that generates a shock wave that travels harmless through the skin and tissues, but breaks the stone into many, many smaller pieces.

There are a number of different kinds of ESWL devices.

One such device transmits the shock waves as the patient reclines in a water bath.

Other devices are placed against a soft cushion next to the patient's body.

Anesthesia is generally required for EWSL, but the procedure is usually done on an outpatient basis. Most people are able to resume normal activities in several days.

Sometimes the kidney stone is not completely shattered, requiring more than one treatment.

ESWL may not be the most suitable treatment for certain kinds of stones, especially those that are unusually large.

Percutaneous nephrolithotomy

This is a procedure that's often used when stone is too big or is seated in a place where ESWL would be ineffective.

A surgeon begins this operation by making a small in the back. An instrument called a nephroscope locates the kidney stone and the doctor removes it.

Patients can expect to stay in the hospital for a few days when percutaneous nephrolithotomy is done. A small tube called a nephrostomy tube is usually left in the kidney temporarily while it heals.

In some cases, percutaneous nephrolithotomy provides a better option than EWSL because there's more certainty that the entire stone has been removed. No fragments are left behind.

Ureteroscopy

Although EWSL is generally effective with some kidney stones in the ureters, a procedure called ureteroscopy may work better for mid-and lower-ureter stones.

The doctor uses a small fiberoptic instrument called a ureteroscope. It passes through the urethra and bladder into the ureter. Once the stone is located, it's removed with a cage-like "basket." The surgeon might also shatter the stone it with a special instrument that creates shock wave.

An incision is not necessary.

Related articles: kidney stones, kidney stone symptoms, kidney stone treatment and kidney stone pain.