PCNL stands for Percutaneous Nephrolithotomy. It’s a surgical procedure used to remove kidney stones that are larger or located in a way that makes other non-invasive treatments like ESWL (Extracorporeal Shock Wave Lithotripsy) less effective. Here’s an overview of the PCNL procedure:

    1.    Preparation: The patient is typically placed under general anesthesia or sometimes regional anesthesia (spinal or epidural) to ensure they are pain-free and sedated during the procedure.
    2.    Guidance and Access: The surgeon uses fluoroscopy (real-time X-ray) or ultrasound to guide a thin, flexible instrument called a nephroscope through the skin and into the kidney, creating a small incision (usually less than 1 cm) in the back or side.
    3.    Stone Removal: Once the nephroscope is in place within the kidney, the surgeon can visualize the stone(s) on a monitor. Specialized tools, such as laser fiber or ultrasound probes, are used to break the stone into smaller fragments. These fragments are then removed using suction or grasping instruments.
    4.    Closure: After all stone fragments are removed, the surgeon may place a temporary drainage tube (nephrostomy tube) through the incision to allow any remaining fluid or debris to drain from the kidney.
    5.    Recovery: The patient is observed in a recovery area until they wake up from anesthesia. They may spend a few days in the hospital, depending on the complexity of the procedure and the individual’s recovery progress.
    6.    Postoperative Care: After discharge, patients will be advised on pain management, hygiene around the nephrostomy tube, and any dietary or activity restrictions. The nephrostomy tube is typically removed when the kidney has sufficiently drained, usually within a few days to a week.

PCNL is an effective method for treating large or complex kidney stones, but it is a more invasive procedure compared to ESWL or ureteroscopy. The choice of treatment depends on factors like the size and location of the stone, the patient’s overall health, and the surgeon’s expertise.