Ureteroscopy
This is a simple surgery that involves fragmentizing the stone. This procedure is used if the stone has entered the ureter. The patient is usually placed under general anesthesia and a ureteroscope is passed through the urethra. Once the stone is located, it can be scooped out. If the stone is too large, it is first broken into small pieces with a laser. This procedure is known as kidney stone laser surgery. After the stone is broken up, the patient is given plenty of water drink. This will help pass the stone naturally.
Lithotripsy
When the stone is present in the kidney or upper ureter, lithotripsy is the preferred method of kidney stone surgery. This procedure makes use of an instrument that breaks up the stone into smaller pieces. The pieces are then passed naturally by the patient. They can be surgically removed. Electrohydraulic lithotripsy uses shock waves to break up the stone. Extracorporeal shock wave lithotripsy makes use of forced impulses that focus on the kidney stone and shatter it into small pieces. Again, the small pieces of the calcium deposit or stone can be passed by urination or removed by surgery. This form of surgery should not be used in pregnant women. It is also not recommended if the stone is very large, or if the patient suffers from with severe medical conditions.
Passing the stone fragments can be very painful and may take as long as three months or more.
Percutaneous Nephrolithotomy
This procedure can be performed under general anesthesia or spinal anesthesia. The surgical procedure is done through the skin of the patient. The surgeon accesses the kidney through a direct route after determining the exact location of the stone. The procedure uses a needle and guiding wire to access the nephrons in the kidney. A nephroscope is inserted and small stones are removed. If the stone is big it may first be shattered using ultrasound probes. The small fragments are then removed.
This type of kidney stone surgery is used to treat stones that are larger than 2 cm. Patients are usually hospitalized for at least 2 to 3 days. Recovery time takes a few weeks.
Open Surgery
Open kidney stone surgery is only used when no other option is available. Open surgery is done when the stone is very large or very solid and does not break into smaller fragments easily.
Open surgery for the removal of calcium deposits is performed under general anesthesia. An incision is made in the patient's back, and the stone is extracted through an incision in the kidney or ureter. This procedure requires prolonged hospitalization. This type of surgery also has a prolonged recovery time.
Kidney stone surgery is serious and is resorted to in less than 5% of cases. In this type of surgery, the doctor opens up the kidney to remove the stones. The patient can have a scar 5 to 10 inches long. Recovery from open surgery takes at least 4 to 6 weeks.
Each time a surgeon cuts through the kidney, it is estimated that the kidney will lose about 20 percent of its functionality.
Posted in: Surgery
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