Stone Clinic

Stone disease is a very common problem all over the world. Approximately 60% of stones can be managed by Lithotripsy and rests of stones need various endo-urological procedures to remove the stones without open surgery.

• P.C.N.L. (Per Cutaneous Nephro Lithotripsy)
• U.R.S. (Uretro Renoscopy)
• Holmium Laser Lithotripsy
• E.S.W.L. By Dornier Compact Delta Lithotriptor
• E.R.C.P. For Stones in CBD

These surgeries are done routinely by well-experienced surgeons in our hospital. We undertake on an average 250-300 endoscopic surgeries every month for treatment of various kinds of renal and biliary stones. Urinary Stones Overview : Hardened mineral deposits formed in kidney are called kidney stones. When waste materials in the urine do not dissolve completely and the kidney is unable to evacuate them crystals and kidney stones are likely to form. There are many types of stones depending upon the type of mineral deposit.

ESWL – Extracorporeal Shock Wave Lithotripsy uses highly focused electromagnetic waves projected from outside the body to crush kidney stones anywhere in the urinary system. The stone is usually reduced to sand-like particles that can be passed in the urine. Large stones may require more than one ESWL session. It can be used for patients of all age groups and those who have heart and breathing problems. Both X-Ray and USG controls are available on this machine. The positioning, focusing, and delivery of shock waves are all controlled by advanced-computerized system with safety cut-offs to prevent damage by human error. Patients need not stay in hospital and can go home the same day.

P.C.N.L. – Percutaneous Nephrolithotomy (PCNL) is the preferred technique for treating large stones (over 2 cm in diameter) within the kidney. It involves keyhole surgery performed through a 1 cm incision in the skin overlying the kidney (see diagram).

• Compared to traditional treatments of large complex stones, there are no disadvantages. Improved techniques and equipment have allowed this type of surgery to be safer than ever before.

U.R.S. – Ureteroscopy is where a long thin rigid telescope is introduced into the upper urinary tract via the bladder (see diagram below). The diameter of the instrument is less than 2 mm and allows visualization of the lower half of the ureter. A small instrument port allows introduction of micro-baskets and laser fibers (0.3 mm in diameter) to manipulate and fragment stones. It is used only to treat stones in the ureter, and cannot treat stones within the kidney (see flexible pyeloscopy info sheet for kidney stone treatment).

Reasons of Stone Formation:

When the concentration of Cholesterol or fats increases in the bile juice it precipitates as stone in the gall bladder. It can occur in all age groups and in both males and females, though more commonly in females. The five ‘F`s’ of Gall Bladder stone diseases are: Fat, Flatulent, Fair, Female of Forty is more likely to have gall stones.

• Gaseous distension or bloating.
• Flatulent dyspepsia.
• Acute abdominal pain along with vomiting and fever.
• Jaundice - This occurs when a gallstone drops down from the gall bladder into the common bile duct resulting in obstruction to the flow of bile, hence causing jaundice.
• Pancreatitis - This occurs when the slipped gallstone in the common bile duct irritates the duct of the pancreas gland leading to inflammation of the gland.

Laparoscopic cholecystectomy is a procedure in which the gallbladder is removed by laparoscopic techniques. Laparoscopic surgery also referred to as minimally invasive surgery describes the performance of surgical procedures with the assistance of a video camera and several thin instruments.

During a laparoscopic surgical procedure small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. The camera and the instruments are then introduced through the ports which allow access to the inside of the patient. The camera transmits an image of the organs inside the abdomen onto a television monitor. The surgeon is not able to see directly into the patient without the traditional large incision. The video camera becomes a surgeon’s eyes in laparoscopy surgery since the surgeon uses the image from the video camera positioned inside the patient’s body to perform the procedure.

Benefits of minimally invasive or laparoscopic procedures include less post operative discomfort since the incisions are much smaller,quicker recovery times,shorter hospital stays,earlier return to full activities and much smaller scars. Furthermore there may be less internal scarring when the procedures are performed in a minimally invasive fashion compared to standard open surgery.

Laparoscopic cholecystectomy is a very safe operation. The overall complication rate is less than 2%. The complication rate for laparoscopic gallbladder surgery is similar to the complication rate for traditional open gallbladder surgery when performed by a properly trained surgeon.

Many thousands of laparoscopic cholecystectomy have been performed in the USA and this operation has an excellent safety record. Some of the important steps in the operation are as follows:

While providing the latest in Surgical Laser Technology to break up stones. The comprehensive kidney stone clinic emphasizes on prevention by conducting a detailed metabolic evaluation offering dietary counseling and if indicated starting medication.

Where surgical intervention is required we have the latest FDA Approved HOLMIUM LASER as well as DORNIER LITHOTRIPTOR for all kinds of stones.