Mayo stand and back table instruments for Percutaneous Nephrolithotomy surgery setup
Clamping & Occluding
Cutting & Dissecting
A Percutaneous Nephrolithotomy, aka PCNL is performed when a patient forms kidney stones that are too large or too hard to extract through a regular lithotripsy or ureteroscopy.
The patient will be positioned prone, and a tube will be placed through the urethra into the kidney so the area can be easily seen under x-ray.
A small incision with a 15 blade is made on the patient’s back in the location where the stone is seen under x-ray. Under fluoroscopy, a tube/sheath will be placed through the incision to the kidney.
A nephroscope will then be put through the sheath for direct visualization to the stone. Instruments can be passed through the nephroscope to break up the stone and pull out the pieces.
A stent is usually placed at the end of surgery to help with drainage.