Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure to remove large kidney stones that cannot pass on their own or are resistant to other treatments, such as shockwave lithotripsy. The procedure involves making a small incision in the back to create a passage into the kidney, then inserting a scope to break up and remove the stone.

Why PCNL is Performed

• Large or Complex Stones: Preferred for very large stones (often > 2 cm) or staghorn calculi that fill the entire kidney.
• Resistant Stones: Used when stones are hard or do not respond to treatments like shockwave lithotripsy or ureteroscopy.

When is PCNL Recommended?

• Kidney stones > 2 cm
• Multiple or staghorn calculi
• Stones resistant to ESWL (shock wave lithotripsy)
• Stones causing obstruction with infection or kidney damage
• Hard stones not easily broken

Advantages

• Higher stone clearance rates for large/complex stones
• Minimally invasive compared to open surgery
• Shorter hospital stay than traditional surgery