Percutaneous Nephrolithotomy
Steps Involved in IVF:
Procedure Description
Percutaneous Nephrolithotomy (PCNL) is a minimally invasive surgical procedure used for the removal of large kidney stones that cannot be passed naturally or treated effectively through non-invasive methods like shock wave lithotripsy. It is particularly beneficial for stones larger than 2 cm, staghorn stones that fill a large portion of the kidney, or stones that are resistant to other treatments. The procedure involves accessing the kidney through a small incision in the back, which allows for direct stone removal.
The procedure starts with a detailed assessment, including imaging tests such as CT scans, X-rays, or ultrasounds, to determine the size, shape, and exact location of the stones. Once the surgical plan is confirmed, the surgeon makes a small incision, about 1 cm, through the skin and into the kidney. Using specialized instruments like a nephroscope, the surgeon breaks down and extracts the stones through this incision.
During PCNL, the use of minimally invasive techniques results in less damage to surrounding tissues, reduced post-operative pain, and quicker recovery times compared to open surgery. This makes it a preferred option for patients with complex kidney stones, especially those who have previously failed non-surgical treatments. It’s also highly effective for patients with multiple stones or stones located in parts of the kidney that are difficult to access.
Procedure Duration
The duration of the PCNL procedure typically ranges from 1 to 3 hours, depending on factors such as the size and number of stones, their location within the kidney, and the patient's anatomy. The procedure is performed under general anesthesia, ensuring that the patient remains comfortable and pain-free throughout. In some cases, regional anesthesia may be used, which numbs only the area being operated on while the patient remains awake.
The procedure can be divided into three main phases. Firstly, an incision is made in the back to create a direct access point to the kidney. In the second phase, a nephroscope—a thin, flexible tube with a camera and tools for stone extraction—is inserted through the incision. The surgeon then uses this scope to locate, break down, and remove the stones, often using a laser or ultrasound to fragment them into smaller, removable pieces. Finally, in the third phase, a drainage tube or catheter is temporarily placed to ensure proper healing and to allow any residual fragments to pass.
After the surgery, most patients stay in the hospital for 1 to 2 days for observation and recovery. During this time, the medical team monitors kidney function, ensures proper drainage, and manages any pain or discomfort. While many patients are able to resume normal activities within a week, full recovery may take a few weeks, depending on individual health and the complexity of the stone removal.
Benefits
- Minimally Invasive:
PCNL requires only a small incision, leading to less trauma to the body, reduced blood loss, and minimized post-operative discomfort.
- Effective for Large Stones:
The procedure is particularly suitable for large, complex, or multiple kidney stones that are not manageable by less invasive methods.
- Quick Recovery:
Compared to open surgery, patients experience faster recovery times, with most able to return to normal activities within a week.
- High Success Rate:
PCNL has a high success rate in stone clearance, significantly reducing the likelihood of recurrent symptoms or the need for additional treatments.
- Improved Quality of Life:
The procedure effectively relieves pain and discomfort caused by kidney stones, improving the overall quality of life.
Potential Destinations
When seeking Percutaneous Nephrolithotomy abroad, it's important to consider destinations known for their advanced healthcare systems, experienced urologists, and cost-effectiveness. Here are five top choices:
- India:
India has become a hub for medical tourists seeking affordable yet high-quality care. With world-renowned urologists and state-of-the-art facilities, the country offers cost-effective PCNL with excellent post-operative care.
- Turkey:
Turkey is recognized for its advanced medical technology and highly skilled specialists. The country's medical centers provide top-notch PCNL procedures at competitive prices, making it an attractive destination for international patients
- Thailand:
Thailand's healthcare system is known for combining high standards of care with relatively low treatment costs. Bangkok, in particular, is home to several hospitals that cater to international patients seeking kidney stone removal procedures like PCNL.
- United Arab Emirates (UAE):
The UAE, particularly Dubai and Abu Dhabi, is quickly emerging as a leader in medical tourism, offering advanced PCNL procedures with a focus on patient comfort and luxury healthcare experiences.
- Mexico:
Mexico is a preferred destination for patients from North America, offering a combination of experienced urologists and affordable treatment costs. The close proximity and short travel time are additional benefits for those seeking PCNL.
Risks & Considerations
While PCNL is generally considered safe, as with any surgical procedure, there are potential risks and considerations:
- Infection:
Post-operative infections can occur, which may require antibiotics or additional medical interventions to manage. Patients are typically monitored closely to prevent this complication.
- Bleeding:
Because the procedure involves an incision through the skin and kidney, there is a risk of bleeding. While most bleeding can be controlled, in rare cases, a blood transfusion may be needed.
- Injury to Surrounding Organs:
There is a small risk of injury to nearby organs such as the intestines, liver, or spleen, depending on the location of the stones and the anatomy of the patient.
- Residual Stones:
Some stone fragments may be left behind after the procedure, potentially leading to recurrent kidney stones and necessitating further treatment.
- Urinary Leaks:
After stone removal, there may be temporary leakage of urine from the kidney. In most cases, this resolves on its own, but additional drainage may be required if the leakage persists.
How to Choose the Right Doctor and Hospital
Selecting the right doctor and hospital for Percutaneous Nephrolithotomy is critical to ensuring a safe and successful procedure. It is important to choose a board-certified urologist who has significant experience in performing PCNL, as their expertise directly impacts the outcome of the surgery. Additionally, the hospital or medical facility should be equipped with modern technologies for imaging, surgical navigation, and stone fragmentation.
When choosing a destination for PCNL, consider factors like the overall reputation of the hospital, patient safety protocols, quality of pre-and post-operative care, and the availability of comprehensive support for international patients. It is recommended to read reviews from past patients, verify accreditations, and understand the hospital's approach to minimally invasive surgeries.
To receive a free quote for this procedure please click on the link: https://www.medicaltourism.com/get-a-quote
Patients are advised to seek hospitals that are accredited by Global Healthcare and only work with medical tourism facilitators who are certified by Global Healthcare Accreditation or who have undergone certification from the Certified Medical Travel Professionals (CMTP). This ensures that the highest standards in the industry are met. GHA accredits the top hospitals in the world. These are the best hospitals in the world for quality and providing the best patient experience. Click the link to check out hospitals accredited by the Global Healthcare Accreditation: https://www.globalhealthcareaccreditation.com
Frequently Asked Questions
What actually happens during hyperstimulation of the ovaries?
The patient will take injectable FSH (follicle stimulating hormone) for eight to eleven days, depending on how long the follicles take to mature. This hormone is produced naturally in a woman’s body causing one egg to develop per cycle. Taking the injectable FSH causes several follicles to develop at once, at approximately the same rate. The development is monitored with vaginal ultrasounds and following the patient’s levels of estradiol and progesterone. FSH brand names include Repronex, Follistim, Menopur, Gonal-F and Bravelle. The patient injects herself daily.
What happens during egg retrieval?
When the follicles have developed enough to be harvested, the patient attends an appointment where she is anesthetized and prepared for the procedure. Next, the doctor uses an ultrasound probe to guide a needle through the vaginal wall and into the follicle of the ovary. The thin needle draws the follicle fluid, which is then examined by an embryologist to find the eggs. The whole process takes about 20 minutes.
What happens to the eggs?
In the next step, the harvested eggs are then fertilized. If the sperm from the potential father, or in some cases, anonymous donor, has normal functionality, the eggs and sperm are placed together in a dish with a nutrient fluid, then incubated overnight to fertilize normally. If the sperm functionality is suboptimal, an embryologist uses Intracytoplasmic Sperm Injection to inject a single sperm into a single egg with an extremely precise glass needle. Once fertilization is complete, the embryos are assessed and prepared to be transferred to the patient’s uterus.
How are the embryos transferred back to the uterus?
The doctor and the patient will discuss the number of embryos to be transferred. The number of successfully fertilized eggs usually determines the number of eggs to be placed in the uterus. Embryos are transferred to the uterus with transabdominal ultrasound guidance. This process does not require anesthesia, but it can cause minor cervical or uterine discomfort. Following transfer, the patient is advised to take at least one days bed rest and two or three additional days of rest, then 10 to 12 days later, two pregnancy tests are scheduled to confirm success. Once two positive tests are completed, an obstetrical ultrasound is ordered to show the sac, fetal pole, yolk sac and fetal heart rate.
Embryoscope©
Built into this technology there is a microscope with a powerful camera that allows the uninterrupted monitoring of the embryo during its first hours of life. In this way, we can keep a close eye on the embryo, from the moment when the oocyte is inseminated and begins to divide into smaller and smaller cells, until it can be transferred to the uterus.
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