All you need to know about Endoscopic removal of stones


1.        What is meant by endoscopic removal of stones?

Kidney (or renal) stones are clusters of little crystals which will kind within the kidneys.Most clusters are too little to cause any issues and pass out of the body within the water.

Sometimes, the clusters will clump along to create larger clusters, which may eventually become big enough to block the urine collecting system in the kidney.Sometimes, they pass out of the kidney down the ureter and out in the urine without causing any problems, but if they are of a large size, they may block the ureter or lodge in the bladder.

Most kidney stones do not cause any symptoms at all, particularly if they are very small and not causing a blockage. However, kidney stones can be painful and cause blood in the urine (haematuria).If the stone passes out of the urinary organ into the duct, it can cause severe pain.Kidney stones can cause an infection.

Endoscopic stone extraction is a procedure to remove one or more kidney stones using an endoscope which is a tube containing a small camera, a light and a device to break up the stone. It is also called percutaneous nephrolithotomy (PCNL).

The procedure is carried out by a urologist and a radiologist. The procedure usually takes two to three hours.

The advantage to use a catheter with contrast medium application below the  stone extraction balloon is in visualizing under fluoroscopy stones during the process of extraction and help define distal bile duct anatomy.

2.        What is the procedure for the removal of stones?

Endoscopic removal of urinary organ stones is often disbursed whereas your patient is on anaesthetic agent, because they need to lie very still throughout the procedure and it cantake a while.

It is important that your patient does not eat or drink anything for a few hours before the anaesthetic. This is called ‘fasting’ or ‘nil by mouth’.Fasting reduces the danger of abdomen contents getting into the lungs throughout and once the procedure.Fasting times are provided in your admissions letter – in broad terms, this is six hours for food (including milk), four hours for breast feeding and two hours for clearfluids before the procedure.

It is equally important to keep giving your patient food and drink until those times to ensure they remain well-hydrated and get adequate nutrition. This may involve waking your patient in the night to give them a drink.

3.        What are the risks involved?

The procedure is quite painful therefore your patient is given pain relief throughout the procedure and can often have a nurse- or patient-controlled pump delivering little quantities ofpainkiller through a drip for on a daily basis roughly subsequently.

As several stones contain micro-organisms, there is a risk of infection.Your patient will receive a course of antibiotics. There is a chance that your patient could bleed from the place where the nephrostomy tube was inserted, but this is very unusual. It is very common for patient to develop a bruise in the area but this will fade in a few days.

Sometimes, water will leak of the urinary organ and collect within the abdomen rather than passing into the nephrostomy tube.If the amount of leakage is small, this should not cause too many problems, but your patient may need a separate drainage tube from the abdomen if the amount increases.

There is an opportunity that the urinary organ can bleed throughout the procedure or presently subsequently.Again, if the amount of blood is less, this could not cause too several issues, however another operation is sometimes required to manage it if the number will increase.