Nephrostolithotomy

Percutaneous nephrostolithotomy (PCNL) is the treatment of choice for large (>2 cm) renal calculi and staghorn calculi. Percutaneous access into the kidney is often achieved by interventional radiologists, either prior to stone surgery or in conjunction with the urology team. Several basic techniques should be considered in gaining access to the kidney to avoid both intraoperative and postoperative complications. In this article, the authors discuss indications for PCNL, techniques for renal access, complications of PCNL, and management of these complications. They also briefly discuss management of post-operative drainage tube(s).