Percutaneous Lithotripsy (PNL)

In 1976 Fernstrom and Johansson first introduced the percutaneous access method to the kidney.
In the 80’s after the development of such tools, especially in Germany, the PNL method became applicable by specialized doctors.

The method can be applied to almost all patients with particular advantages in children and obese patients. It can also be used in combination with ESWL (sandwich method) so that stones of any size can be removed without open surgery and with minimal injury to the kidney and the patient.

The procedure is performed under complete anesthesia.
After first placing a ureter catheter in the corresponding kidney to prevent the loss of fragments in the ureter and to be able to administer shading fluid to the pelvic floor system, the patient is placed in a prone position.

Using ultrasound, ballistic or electro-hydraulic waves, or LASER the stone is crushed and the fragments are aspirated or extracted directly with forceps. After the operation, a nephrostomy is placed, which is removed after 24 hours following a radiological examination.

With this method, ureteral strictures or other abnormalities of the pelvic system can be treated in the same session.

Percutaneous lithotripsy is currently the first choice for kidney stone removal and has almost completely replaced open surgery in the last 20 years.