Percutaneous nephrolithotomy (PCNL) is a minimally-invasive procedure to remove stones from the kidney by a small puncture wound (up to about 1 cm) through the skin. It is most suitable to remove stones of more than 2 cm in size and which are present near the pelvic region. It is usually done under general anesthesia or spinal anesthesia.
For kidney and ureteral stones that are too large (usually larger than 2 centimeters), too numerous, or too dense to be treated by extracorporeal shock wave lithotripsy (ESWL) or ureteroscopy, PCNL (percutaneous nephrolithotomy or stone extraction) offers a minimally invasive method of removing these stones.
Historically, large kidney and ureteral stones were removed through open surgery, requiring a large flank incision. Percutaneous nephrolithotomy is performed through a 1-cm skin incision and thus minimizes incision size, pain, blood loss, blood transfusions and shortens hospitalization. This technique also has a higher success rate for clearing all stones in one setting than other techniques such as ESWL, which often require several procedures.
