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PCNL

Percutaneous Nephrolithotomy (PCNL) Kidney stones are formed in the urinary tract due to the crystallization of chemical compounds in the urine. PCNL is a technique used to remove certain stones in the kidney or upper ureter (the tube that drains urine from the kidney to the bladder) that are too large for other forms of stone treatment such as shock wave lithotripsy or ureteroscopy. The Surgery This procedure has been performed on many patients over the last several years and is an accepted standard of care for patients with kidney stones that are large, very firm, or resistant to other forms of stone treatment. As such it has replaced open operations for kidney stones in the vast majority of patients. Typically, the length of the surgery is one to two hours. The surgery is performed by making a small 1 cm incision in the patient’s flank area. A tube is placed through the incision into the kidney under x-ray guidance with the help of a C-Arm. A small telescope is then passed through the tube in order to visualize the stone, break it up and remove it from the body. If necessary a laser or other device called a lithotripter may be used to break up the stone before it can be removed. This procedure has resulted in significantly less post-operative pain, shorter hospital stays, and an earlier return to work and daily activities when compared to open stone surgery. This technique also has a higher success rate for clearing all stones in one setting than other techniques such as extracorporeal shock wave lithotripsy (ESWL), which often require several attempts. Potential Risks and Complications Although this procedure has proven to be very safe, as in any surgical procedure there are risks and potential complications. The safety and complication rates are similar when compared to open surgery. Potential risks include: Bleeding Infection Tissue / Organ Injury Conversion to open surgery Failure to Remove the Stone

Cholecystectomy (Removal of Gall Bladder)

You’ve had painful attacks caused by gallstones. To treat the problem, your doctor advised to remove your gallbladder? This surgery is called cholecystectomy. Removing the gallbladder can relieve pain. It will also prevent future attacks. You can live a healthy life without your gallbladder. You may also be able to go back to eating foods you enjoyed before your gallbladder problems started. There are 2 methods for removing the gallbladder. We will choose which method is best for you: Laparoscopic cholecystectomy. This is most common. During surgery, 2 to 4 small incisions are made. A thin tube with a camera is used. This is called a laparoscope. The scope is put through one of the incisions. It sends images to a video screen. Surgical tools are put through other incisions. The gallbladder is removed using the scope and these tools. Open cholecystectomy. One larger incision is made. The surgeon sees and works through this incision. Open surgery is most often used when scarring or other factors make it a better choice for you. In some cases, safety requires a change from laparoscopic to open surgery during the procedure.

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