Percutaneous nephrostolithotomy involves treating kidney stones in the kidney by making a one-inch incision in the back and creating a tunnel through the kidney to the stone.

Through the tunnel the doctor uses a fiberoptic telescope (nephroscope) to either remove the stone or break it up into tiny pieces using a laser, ultrasound probe, or pneumatic device (jack-hammer).

After the procedure a tube is placed in the kidney (nephrostomy tube) and the ureter (stent) to drain the kidney and allow it to heal. The doctor will remove these after X-rays have shown that the kidney has healed and all the stones have been removed.

X-rays will be done on the day after surgery to confirm that all of the stones have been removed. If stones are still present then another procedure (2nd look) will be performed to remove any remaining fragments.

  • Success rates: 70-99% depending on stone size and location
  • Possible complications: Bleeding, infection, urinary injury, pneumothorax (air around the lung), adjacent organ injury
  • Hospital stay and recovery: 1-2 day hospital stay with 2-4 weeks until back to full activity

OPEN STONE SURGERY

Open stone surgery involves making an incision with a knife to remove stones. While this was the original form of treatment for all stones, today it comprises < 5% of all treatments for renal stones.

Because of the expertise of our faculty in removing stones in a minimally invasive fashion at Emory, we rarely if ever resort to this treatment option.