Dr. Jessica LangeQ: I recently had a kidney stone and wanted to know more about my options. What types of minimally invasive surgery are available to treat kidney stones, and can they be prevented?
A: Recent advances in laser technology and digital scopes allow us to now, better than ever before, remove virtually any kidney stone with either a small incision or no incision at all and with limited postoperative recovery time. Stones that give many patients terrible pain and trouble can be removed effectively with minimally invasive techniques. There are three ways to surgically treat kidney stones.
» Shock wave lithotripsy: Shock waves are aimed at a stone in the kidney or ureter from outside a patient's body. These waves cause the stone to break into pieces, which the patient then passes. It requires no incisions and can be done under sedation or general anesthesia. It is only suitable for smaller stones in favorable locations.
» Ureteroscopy: A lighted digital camera is passed through the patient's bladder and into the ureter or the kidney, where the stone is encountered. A tiny laser fiber is used to fragment the stone or stones, and a small basket is used to remove the fragments. This surgery requires no incisions but does require general anesthesia. This procedure does not require the patient to pass the stone fragments on his or her own, and it is typically an outpatient procedure where the patient can return home the day of surgery.
» Percutaneous nephrolithotomy: This procedure is used to remove large kidney stones. A 1-centimeter incision is made in the patient's back, and a lighted camera and vacuum-type device are used to break and remove the stone. This technique can be used to remove very large kidney stones with only one or two small incisions. This procedure requires general anesthesia and most commonly an overnight hospital stay.
Yes, kidney stones can be prevented. We send any available stone fragments for analysis as well as a few simple blood and urine tests to determine why the patient is at risk for making stones. We can then introduce dietary modifications, appropriate vitamin supplementation and potentially medical therapy to reduce future risk.
- Dr. Jessica Lange, Erlanger Urology; member, Chattanooga-Hamilton County Medical Society