Kidney Stone Removal is a procedure involves breaking the stones using techniques like lithotripsy, ureteroscopy or nephrolithotomy. In most cases, these stones can be passed out of the body through urine once they are broken into smaller pieces.
There are 3 main techniques for removing kidney stones:
1.Lithotripsy is the most widely used procedure for kidney stone removal. It can be performed in following 3 ways
Extracorporeal Shock Wave Lithotripsy (ESWL) is a non-invasive procedure. This procedure is generally used for soft stones preferably smaller than 2cm diameter.
Laser Lithotripsy is a surgical procedure. Larger and harder stones can be disintegrated using laser lithotripsy. It is generally advisable to go for laser lithotripsy for kidney stones.
Holmium Laser Lithotripsy is an improved laser lithotripsy procedure.
2. Ureteroscopy is a surgical procedure performed by inserting ureteroscope in the urethra.
3. Percutaneous Nephrolithotomy is used when lithotripsy and ureteroscopy does not prove sucessful. It is used for comparatively larger kidney stones.
The indications for Kidney Stone Removal procedure include:
Excessive pain in the organs
Damage to the organ and loss of function of the organ where the stone is present
Infections arising in the urinary tract of the body
Internal bleeding in the organs surrounding kidney
The stone blocking regular flow of urine
The tests to be carried out before the procedure include:
A complete physical examination, carried out to determine the size, location and number of stones present in the body
A pregnancy test is done for women of child bearing age to make sure that the woman is not pregnant as the shockwaves and lasers can harm the baby.
For patients of elderly age, an EKG test is performed to ensure that the patient does not suffer from any potential heart disease.
Tests for allergic reactions are carried out to ensure that the patient is not allergic to any of the components of the medications and fluids used in the lithotripsy treatment.
Kidney Stone Removal procedure is generally performed by an experienced urologist.
1. Lithotripsy - In this procedure, the kidney stones are broken down into small pieces using either of the below mentioned techniques. The broken pieces are passed out of the body via urine. A standard lithotripsy procedure is completed within 45 minutes to an hour.
Extracorporeal Shock Wave Lithotripsy (ESWL) involves high intensity acoustic pulses applied externally in an attempt to break up the stone with minimum collateral damage. The high energy shock waves are passed through the body until they hit the stone in the body and break it up into finer fragments. It is advisable to use ESWL for patients of diabetes and hypertension and the patients having a solitary kidney.
In Laser Lithotripsy, athin scope is inserted into the urinary tract of the patient to observe the position of the stone. Once the stone is located, a laser fibre is passed through the working shaft of the scope and high intensity laser beams are emitted directly to the stone to disintegrate it. Larger and harder stones can be disintegrated using laser lithotripsy.
Holmium Laser Lithotripsy is an improved laser lithotripsy procedure. During this process holmium laser, emitting infra red beams (2100nm wavelength), is used to disintegrate the stones. This process is specially used for stones, which are large in size or have a high concentration
2. Ureteroscopy - An incision is made in the body to insert a ureteroscope (a viewing instrument) into the urethra. Ureteroscope is then via bladder and ureter and kidney stone is located. Using forceps, stone is grabbed and removed surgically.
3. Percutaneous Nephrolithotomy - It is an elaborate surgery which is performed under general anesthesia. The surgeon puts a cut in the back of the body to insert a tube into the kidney via bladder. X-ray will be used to find the exact location of the stone and access them. If the stone is large to fit the tube, then it is broken into smaller pieces. Stones are drained through the tube.
The patient is generally discharged on the same day if lithotripsy is used. In case of ureteroscopy and percutaneous nephrolitotomy, the patient has to stay in hospital for 1 to 2 days.
Tests like X - ray and ultrasound are carried out after a few days to make sure that none of the stone particles are left behind.
The recovery time after this procedure ranges between a few days to several weeks depending on the condition of the patient before the procedure and the effects that the stone had on the organ. If there are no complications following the procedure, the patient can recover completely in a week’s time.
The doctor will recommend increasing intake of water considerably. The patients are advised to limit the intake of foods with high protein content and salt. Meats, bananas, pulses, nuts, coffee and green leafy vegetables should be avoided during the recovery period.
Risk and Complication
Patients may witness some side effects after the procedure. These include:
Small pieces of stones lodged into the ureters, blocking the flow of urine from the kidneys to the bladder.
Abnormality developing in the kidney function.
Bleeding around the organ after the procedure.
The lithotripsy cost varies with the type of lithotripsy procedure performed for the patient. The general cost of ESWL process ranges between Rs. 15000 to Rs. 35000.
Lithotripsy cost for laser and holmium laser procedures may vary from Rs. 50000 to Rs. 80000.
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