Q | the PCNL procedure
A | PCNL is carried out under a general anaesthetic. The first step is to examine the bladder with a telescope and to pass a fine tube up into the ureter (the pipe with connects the kidney to the bladder). A urinary catheter is also placed into the bladder at this time.
You are then positioned face down whilst asleep and X-ray contrast (dye) fluid is injected up the tube in your ureter. This outlines the kidney system on X-ray so that a fine hollow needle can be inserted directly into the kidney from the back. Once in the kidney, a guidewire is passed down this needle and a track can be widened into the kidney (about the size of a large ball point pen).
This track allows the surgeon to insert the nephroscope and find the stone. Special instruments can then be passed down the nephroscope to break up the stone and remove the fragments. The operation usually takes 1-2 hours to perform. At the end of the procedure, a drainage tube is placed down the track and stitched in temporarily to allow any blood and debris to drain over the next 24 hours.