Remove kidney stones

Kidney stones is a complication that can arise from subjective predisposition or for factors such as obesity, unbalanced diet, poor hydration, infections, or simply because a subject eliminates excess substances such as calcium or uric acid or has to a lesser extent, in the body, chemicals such as citrates or magnesium that prevent their formation.

Removing Kidney stones by surgery

Usually, this procedure is practiced only in case of large and complex kidney stones, such as mold stones. A stencil stone is a stone that extends into large sections of the renal pelvis or one or more renal calyxes.

 Percutaneous nephrolithotripsy (PCNL) involves the removal of kidney stones by creating an artificial opening in the back. To do this, the kidney is pricked from the hip directly through the skin. 

This allows an endoscope to be inserted into the collecting apparatus of the kidneys, where the stone is located. This is usually done under general anesthesia. 

The urinary tract is prepared for the operation with the patient in the lithotomy position. After that, the patient is turned over on his stomach so that he is face down. This allows you to perform the surgery on your back.

The puncture occurs under visual control using radiographic and ultrasound imaging. Once the endoscope, which can be the thickness of a pencil, has been inserted into the kidney, it is possible to crush the stone with a laser or ultrasound probe and then remove the pieces.

 To finish the operation, a catheter is inserted into the kidney (external urinary derivation via the flank) or a ureteral stent (internal derivation) to avoid obstruction of the urinary flow.

Usually, the patient has to stay in the hospital for three to five days. If the procedure is performed by an experienced surgeon, the complication rate is usually low.

Kidney stones: what are the surgical options?

Stones that fail to proceed into the ureter must undergo surgical treatment. It is possible to resort to different techniques, the choice of which naturally depends on the characteristics, size, location, and several stones. Surgical procedures include;

EXTRACORPOREAL LITHOTRYSIS

PERCUTANEOUS RENAL LITHOTRISSY

URETRORENOSCOPY  (endoscopic urethral lithotripsy)

OPEN SURGICAL TREATMENT

Remove kidney stone procedure

EXTRACORPOREAL LITHOTRYSIS: consists of the fragmentation of small stones from outside the body, which are subsequently eliminated in the urine. This therapeutic method is minimally invasive and is mainly used for some calcium oxalate stones, struvite stones, and uric acid stones. On the contrary, the calculations of cystine and those of oxalate calcium monohydrate do not respond well to extracorporeal technique, therefore, are generally removed by percutaneous or transurethral lithotripsy;

PERCUTANEOUS RENAL LITHOTRISSY: it is performed through a hole at the lumbar level from which one enters with an instrument that allows the destruction of the stone and the aspiration of the fragments;

URETRORENOSCOPY  (endoscopic urethral lithotripsy): another solution is endoscopic removal. In practice, thin probes are introduced through the urethra, along the urinary tract, to reach the point where a small stone has stopped, to mobilize it, and make it go down into the bladder. An endoscopic method, which can always be performed by penetrating through the urethra and moving up from the bladder to the ureter, is ultrasound ureteroscopy. This procedure allows you to get to the stone and break it into fragments, which can then be eliminated together with the urine or removed with small pliers or "baskets".

OPEN SURGICAL TREATMENT: in cases so complex that the endoscopic approach is not recommended, it may be necessary to resort to open surgery, which involves opening the abdomen.

To know more on the various ways to Remove Kidney Stones CLICK HERE

            Remove kidney stones by laser

What is laser lithrotrissia?

Laser lithrotrissia is a surgical technique used to remove kidney stones using wave types: ultrasonic, electrohydraulic, or shock. 

The holmium laser, in particular, is among the most advanced techniques and allows the treatment of urethroscopy or endoscopy, using a laser beam of thermal energy that eliminates the obstructive tissue.

 This is a minimally invasive procedure that is usually done under local anesthesia or mild sedation to eliminate the pain of the surgery.

Why is it performed?

Laser lithrotrissia is used to fragment all types of kidney stones, whether they are cystine, calcium oxalate monohydrate, or brushite (calcium phosphate). It offers:

Great effectiveness in fragmenting any calculation

Maximum surgeon control during treatment as the laser introduces minimal propulsion or movement into the stone

Optimal use of fibers of different calibers and of great flexibility, which can be used with any endoscope

What does it consist of?

Laser lithrotrissia (remove kidney stones with laser) is a minimally invasive technique. Access to kidney stones is through a puncture in the skin at the lumbar level or the urethra to the bladder or ureter, depending on where the stone is located. 

Introduced is an optical fiber tube with a rigid and flexible tip, connected to a camera. Once the stones are located, they are fragmented with laser pulsation. The energy contained in the laser allows you to act quickly on the calculation.

Preparation for laser litrotrissia (remove kidney stones with laser)

Before carrying out laser lithotripsy(remove kidney stones with laser), the patient must communicate to the doctor:

If you are or might be pregnant

The medications you are taking

In addition, the doctor may request, in the days before the surgery to stop taking acetylsalicylic acid, anti-inflammatories, or drugs that make it difficult for blood to clot. On the day of the procedure, the patient must:

Do not drink or eat for several hours before surgery

Take the medications indicated by your doctor accompanied only by a small sip of water

Care after surgery

Inserting an endoscopic instrument into the urinary tract can cause it to swell, which can, in turn, obstruct the passage of urine from the kidney to the bladder. Consequently, a catheter should be temporarily placed within the urinary tract. Although it is slightly annoying, it is useful for carrying out normal urination.

 In addition to the discomfort of the urethral catheter in some cases, there may be slight bleeding in the urine, which does not last for more than 5 days.

It is always recommended that the patient be accompanied, even though it is an outpatient procedure, and that he be accompanied home. Once at home, rest and taking antibiotics and anti-inflammatories are indicated. 

The following day the patient can already return to daily activities. However, It is necessary to drink plenty of fluids in the following weeks: 8-10 glasses per day, to help remove debris. One month after the procedure, the patient will have to undergo a metabolic examination, with an evaluation of urine and blood for 24 hours, to study the factors that can intervene in the formation of stones. To this is added a 

                      remove kidney stones without surgery

Extracorporeal shock wave lithotripsy is the non-invasive procedure par excellence and is indicated when the stone is placed in the kidney and has a small size (less than 1.5 - 2 centimeters). 

The patient is made to lie down on the machine (lithotripter) by placing his side on a pillow filled with water. The calculation is shattered thanks to the shock waves generated by the machine and all conveyed to the calculation. The treatment does not include anesthesia, does not require hospitalization, and has a duration of 45-60 minutes.

 The stone fragments are then excreted in the urine over the next few days.