Mini Supine PCNL

What is Mini Supine percutaneous nephrolithotomy?

Percutaneous nephrolithotomy is a procedure to remove large stones from the kidneys or ureters. Mini supine percutaneous nephrolithotomy is a modification to standard percutaneous nephrolithotomy technique to improve post-operative recovery and reduce the risk of complications such as post-operative pain, bleeding and lung atelectasis.

What are the indications for Mini-Supine percutaneous nephrolithotomy?

The procedure is indicated for large stones in the kidney which is too big to treat with ESWL or laser ureteropyeloscopy. Stones smaller than 5 cm are generally suitable for treatment with the mini supine percutaneous nephrolithotomy technique.

How is mini supine PCNL performed, and what are the benefits compared to conventional PCNL?

The patient is positioned lying face up on the operating table rather than the prone (face down) position usually used with PCNL. This allows easier and safer airway control by the anaesthetist, and is safer for patients who are overweight or have cardiac problems. It also allows the surgeon to perform ureteroscopy at the same time if this is required.

A 16 French tube (circumference is 16 mm) is inserted through the kidney to treat the stones with mini-PCNL compared to 30 French tubes (circumference is 30mm) used in PCNL. This causes less damage to the kidney and reduces bleeding. A kidney drainage tube is usually not required with mini-PCNL.

The stone is blasted into fragments with a laser fiber and stone fragments are flushed out through the hollow tube.

Patients can normally go home the next day following supine mini PCNL surgery.