Ureteroscopy
Of the three kinds of surgery that can be performed on kidney stones, uteroscopy is the least invasive because it involves no incisions. A ureteroscopy involves the use of a small instrument with a fiber optic camera (called a ureteroscope). This device is passed through the urethra (which is the tube that carries urine from the bladder for urination and then through the bladder and up through the ureters, which connect the kidneys to the bladder. From there, the kidney stones can be visualized using the fiber optic camera on the device. Small stones can then be removed using a small basket that is attached to the ureteroscope. Larger stones can be broken up with a laser beam and then retrieved and removed using the remotely controlled basket attached to the uteroscope.
Percutaneous Nephrolithotomy
A percutaneous nephrolitotomy can be used for kidney stones that cannot be removed with a uteroscope. With this kind of procedure, a small incision (according to the American Urological Association, only 1 centimeter in length) is made in the flank, and a guide wire is threaded through this incision into the kidney. The area around the guide wire is then expanded using dilators, and then a small device called a nephroscope is passed along the guide wire into the kidney. This device is used to locate the kidney stones which can then be broken into smaller pieces using ultrasonic waves (or laser light) and removed via suction. The kidney stones can also be manually removed by a urologist because the guide line canal allows for the insertion of small instruments which can be used to seize and pull out the stones.
Open Surgery
Once the standard method of treating kidney stones, open surgery on the kidney is now reserved for very large stones or for patients who have stones that are causing serious complications. This type of surgery involves a large incision being made in the flank to gain access to the affected kidney. Then additional cuts are made either in the ureter or in the kidney itself to gain access to the stone, which is then removed. Once the stone is removed, the kidney flap is replaced and sewn up, as well as the initial incision. This procedure is infrequently utilized because it carries a longer recovery time and a greater risk of infection and kidney damage.
