Keyhole surgery through a small tract in the back directly into the kidney - the most effective way to clear large or stag-horn stones in a single procedure.
Percutaneous nephrolithotomy - "PCNL" - is a keyhole operation that goes directly into the kidney through a small puncture in the back. A working telescope is passed down the tract, and instruments and lasers are used to break up and remove the stone in fragments. It is the gold-standard treatment for large kidney stones, including stag-horn stones that fill the collecting system.
PCNL is not typically used for small stones, which are better suited to ureteroscopy or shockwave treatment.
Under general anaesthetic:
A CT is reviewed to plan the best angle of entry. A clean urine sample is confirmed before surgery - infection is treated first.
Typically 1–3 hours depending on stone burden.
Most patients stay 1–3 nights. A temporary drainage tube is usually removed before discharge.
Most people are back to normal activity within 2–4 weeks. Strenuous exercise and heavy lifting are paused for about 4 weeks.
A CT or X-ray confirms stone clearance; any remaining stent is removed in a brief procedure.
No. PCNL uses a small puncture through the back, typically under 1 cm. The scar is small and usually hidden in a skin crease.
For most patients, yes. For very large or complex stones, a planned staged approach may be needed to achieve complete clearance safely.
In selected patients, the external drainage tube can be omitted at the end of surgery, which usually means less post-operative pain and a shorter hospital stay. Dr Kooner will discuss whether this is suitable for you.
Yes. Once the stones are cleared, fluid intake is the single most important factor in preventing new stones. You will be given a tailored prevention plan.
Arrange a consultation or request a second opinion on kidney cancer, stones, or reconstructive kidney surgery.