Percutaneous nephrolithotomy: an extreme technical makeover for an old technique

Area of Science:

• Urology
• Nephrology
• Surgical Innovation

Background:

• Percutaneous nephrolithotomy (PNL) is the preferred treatment for complex kidney stones.
• PNL is indicated for large, cystine, struvite, lower pole, and anatomically challenging stones.
• Obese patients with kidney stones also benefit from PNL.

Purpose of the Study:

• To review recent advancements in PNL techniques.
• To evaluate if these changes improve stone-free rates and reduce patient morbidity.

Main Methods:

• Comprehensive literature review of recent urologic studies.
• Identification of PNL technique alterations and their impact.

Main Results:

• Supine PNL demonstrates safety and offers patient/surgeon benefits.
• Advanced lithotripsy devices enhance stone fragmentation and clearance.
• Tubeless, stentless PNL reduces post-operative pain and discomfort.

Conclusions:

• Further PNL advancements promise better stone clearance and reduced complications.
• Supine PNL, improved lithotripsy, and tubeless PNL require more clinical trials.
• These innovations significantly decrease peri-operative patient morbidity.