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With the evolution of urological procedures, various techniques have been developed to address kidney stones. From traditional open surgery to less invasive approaches, the quest for improved outcomes and reduced patient morbidity has driven innovation. Supine Mini Percutaneous Nephrolithotomy (PCNL) represents a notable advancement in this trajectory, offering a promising alternative to existing methods for kidney stone removal.
Kidney stones, also known as renal calculus, are hard, solid crystallized deposits that form in the kidneys or urinary tract called ureters. They are made up of minerals and salts that normally dissolve in your urine, but due to factors like dehydration or certain diets, they clump together and form stones.
Kidney stones are more common than you think, affecting 1 in every 10 adults between the age group of 30 to 60 years. These prevalent deposits can cause immense discomfort and even harm your kidneys if ignored. Smaller stones often pass through urine, but larger kidney stones need medical management, often surgical interventions to remove the stones and get rid of the pain.
Synopsis
Supine Mini PCNL for Kidney Stone Removal
Supine Mini Percutaneous Nephrolithotomy (PCNL) is an innovative approach in urology that combines the benefits of a supine position (lying with the face and torso facing upwards) with the efficiency of miniaturised instruments for kidney stone management. This evolving technique has garnered attention for its potential to enhance surgical outcomes and patient comfort by reducing complications and improving overall surgical efficacy.
Advantages of Supine Mini PCNL
The most common advantages of Supine Mini PCNL for kidney stone removal are mentioned below.
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Minimised Patient Position Changes
The traditional PCNL often involves repositioning the patient from supine to prone or lateral. Contrarily, the supine approach streamlines the surgical process. This minimises disruptions, enhances workflow, improves efficiency, and reduces the overall surgery duration.
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Enhanced Visualisation and Access to the Kidney
Supine Mini PCNL offers improved visualisation and access to the kidney. It provides urologists with a clearer view of the targeted stone and surrounding structures. The supine position facilitates a more direct path to the kidney. This enables precise stone targeting, contributing to improved outcomes while reducing the risk of damage to adjacent tissues.
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Reduced Blood Loss and Complications
The minimally invasive nature of this technique reduces blood loss. The meticulous control offered by the supine position allows for a more controlled surgical environment. With decreased blood loss, it also aids in reducing complications, promoting a safer surgical experience.
Consult our urology hospital in Bangalore if you need kidney stone surgery.
Supine Mini PCNL Surgery
In the realm of stone management, Supine Mini PCNL emerges as a promising technique. It offers several advantages, and its effectiveness for larger stones is precise. The suitability of the Supine Mini PCNL technique is determined by an experienced urologist in Bangalore, depending on several conditions. The most common ones are as follows:
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Medium or larger kidney stones.
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Location of the stones in the renal pelvis or upper calyx.
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Patients who are unfit for or prefer alternatives to prone PCNL. This can be due to comorbidities, body habitus, etc.
A thorough analysis of the patient’s health condition is crucial to maximise the benefits and ensure optimal outcomes.
Preoperative Planning
Preoperative planning for Supine Mini PCNL involves detailed imaging studies such as non-contrast CT scans for accurate visualisation of the kidney size, location, and composition. 3D reconstructions further help in the identification of anatomical variations and planning the optimal entry point accordingly.
The individualised nature of Supine Mini PCNL allows urologists to tailor the surgical approach based on patient characteristics. Such a personalised approach maximises the effectiveness of the procedure while minimising complications.
Surgical Procedure
In Supine Mini PCNL, patients are positioned in the supine lithotomy position. It eliminates the need for repositioning during surgery. This optimised approach provides direct access to the kidney without the logistical challenges associated with prone PCNL. Our top urologist meticulously selects the entry point based on preoperative imaging, ensuring a streamlined approach to the target stone.
The different imaging techniques used by surgeons include:
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Fluoroscopy
It offers real-time imaging to target and locate kidney stones precisely.
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Endoscopy
It allows the doctor to navigate the renal anatomy with accuracy.
The combination of these two ensures successful stone clearance. Supine Mini PCNL uses miniaturised tools. Smaller scopes, baskets, and probes facilitate access and manoeuvrability within the kidney while minimising trauma to surrounding tissues.
During surgery, continuous assessment and adaptation are crucial. Intraoperative considerations include:
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Monitoring potential complications.
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Adjusting the approach based on real-time feedback.
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Ensuring comprehensive stone clearance.
After the Surgery
Postoperative imaging, typically using non-contrast CT scans, can evaluate the success of this procedure. This assessment ensures effective stone clearance and identifies any residual fragments that may require additional intervention.
Post-operative Care
Supine Mini PCNL ensures reduced postoperative pain compared to traditional approaches. This is attributed to the minimised trauma to surrounding tissues and the smaller incision size. Postoperative pain management involves tailored approaches. It includes analgesics and anti-inflammatory medications.
The recovery period in this procedure is also faster. Follow-up protocols include:
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Regular assessments to monitor renal function.
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Imaging to confirm stone clearance.
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Consultations to address any postoperative concerns.
Clear communication of postoperative care instructions ensures optimal recovery and long-term urological health.
Consult the best urologist in Bangalore at the Manipal Hospitals, Old Airport Road, and ensure the correct diagnosis and treatment plan.
FAQ's
Supine Mini PCNL is particularly effective for larger stones. The suitability can also be determined by the stones’ specific characteristics and the patient's overall condition.
Supine Mini PCNL generally offers a faster recovery time compared to traditional PCNL and other kidney stone removal interventions.
The minimally invasive nature of Supine Mini PCNL reduces blood loss and lower complications, promoting a safer surgical experience. The meticulous control offered by the supine position allows for a more controlled surgical environment.
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