Endoscopic kidney stone surgery: When is it indicated?

Along with extracorporeal lithotripsy, laparoscopic kidney stone surgery is a way to remove stones in the renal parenchyma with minimal invasiveness. This is a very common endoscopic indication in the field of urology, helping patients both get rid of renal colic pain, preserve kidney function and avoid major surgery according to traditional methods.

Laparoscopic surgery is a form of minimally invasive surgery. The process is usually done through very small skin incisions, and everything that takes place inside the body is controlled through a monitor outside the body.
Laparoscopic kidney stone surgery is a way to intervene to remove stones formed in the kidney parenchyma through endoscopic passage. With the advantages that laparoscopic surgery brings not only in the field of general surgery but also in urogenital surgery, patients with kidney stones have an additional optimal treatment method and high safety.

The endoscopic intervention to remove stones only when the patient has suitable indications. These are the following conditions:
Symptomatic kidney stones: the patient goes to the doctor because of persistent dull back pain, renal colic, hematuria, urinary urgency, painful urination, fever and shivering during infections. prolonged or frequent urination. Asymptomatic kidney stones 10 to 20 mm in size Kidney stones over 20 mm in size. All of the above indications are determined through history, clinical examination and necessary tests such as urinalysis, abdominal ultrasound, X-ray, computed tomography... to assess Assess the exact size and location of the stone in the renal parenchyma before intervention.
For cases that are experiencing acute complications of kidney stones such as septic shock, pyuria, renal abscess, renal failure, unique kidney, laparoscopic kidney stone surgery is not the method of choice. this time. Instead, the patient will be placed a ureteral catheter, emergency nephrostomy or open surgery to remove stones.

After determining that the patient has a suitable indication for laparoscopic kidney stone surgery, the patient is scheduled to have a preoperative plan. The anesthesiologist will perform a general examination to ensure organ function can withstand the anesthesia and surgery.
Inform the urologist before deciding to have surgery if you have the following conditions:
Artificial heart valve Coronary artery stent Pacemaker or defibrillator Artificial joint replacement Vascular transplantation artificial shunt neurosurgery Any other transplanted organ Being treated with warfarin, aspirin or clopidogrel Having an infection in another organ. On the day before admission, the patient will be asked not to eat or drink for 6 hours before surgery. After that, you will be instructed to clean your body with an antiseptic solution, change into appropriate clothes and arrange an appropriate posture on the operating table, and place a urinary catheter.
Anesthesiologist will give general anesthesia, the patient will quickly fall asleep and breathe through the endotracheal machine.

When the patient has been assured of complete anesthesia, the urologist will make an incision.
A small incision is made in the pelvis or near the renal fossa depending on the location of the stone in order to achieve the closest approach to the kidney stone. The doctor will also make additional skin incisions to insert the laparoscopic instruments into the abdomen. Thereby, the images inside the abdomen, approaching the kidney parenchyma and removing stones will be observed and controlled by manipulation through the external screen.
Then, a ureteral stent is usually placed to secure the exit of the stone debris, as well as other associated stones.
Finally, the renal parenchyma is closed and the endoscopic instruments are withdrawn one by one. Incisions on the abdominal wall were sutured with absorbable or non-dissolving sutures, wound dressings, breathing tubes removed and the patient transferred to the recovery room after surgery.

When fully awake, breathing spontaneously, vital signs are stable and urine drainage is good, the patient will be discharged from the postoperative room and returned to the private room.
At this point, you are always encouraged to eat and drink as soon as you feel able after surgery. You will also be encouraged to get active again as soon as possible. This helps prevent blood clots from forming in the legs, traveling to the lungs, as well as rapidly improving bowel function after the effects of the anesthetic. If the pain is limiting your activity, you can take a common pain reliever such as paracetamol.
The urinary catheter is usually removed the morning of the next day after surgery and the patient needs to return to normal urination habits. Patients are also advised to drink plenty of fluids to increase urinary output.
How long does laparoscopic kidney stone surgery take to heal? The expected hospital stay after nephrolithoscopy is 3 days. Some patients are able to go home earlier. Before leaving the hospital, the doctor will advise on how to take care of the wound and when to re-evaluate later. A kidney stone surgery wound can take 10 to 14 days to fully heal, and most people can return to normal activities in 2 to 4 weeks. The ureteral stent will also be removed after 4 to 6 weeks.
In addition, similar to other surgical interventions, laparoscopic kidney stone surgery may also have risks. Therefore, patients also need to know how to recognize and re-examine early when post-operative complications are suspected, including:
Incision bleeding Incisional infection Intra-abdominal hematoma Peritonitis Dynamic thrombosis Vein - Vein Trauma to nearby organs such as great blood vessels, spleen, liver, kidney, lung, pancreas, intestines... A few of these cases require surgery to repair, usually require open surgery instead of repeat laparoscopic surgery.
Laparoscopic kidney stone surgery is indicated in cases of kidney stones with simple symptoms without causing complications. With the advantages of endoscopic technique, the stone removal procedure will become gentle, less painful, fast recovery time and highly aesthetic for the patient. However, it is necessary to consider choosing a reliable and professional laparoscopic surgery facility to have an effective and safe surgery.

At Vinmec International General Hospital, endoscopic small-tunnel kidney stone lithotripsy is performed, with strengths in treatment such as:
Experienced doctors in lithotripsy Modern equipment, high treatment efficiency Treatment indications are based on thorough examination, avoiding technical abuse and minimizing side effects for the patient, complications In case of abnormalities such as The stone has not broken or has broken but still remains, the doctor will consult and conduct other lithotripsy methods to thoroughly solve the disease Professional service: Modern civilized disease prevention system, one room for each patient Patients are comprehensively served from monitoring disease parameters, meals, rest, exercise, health education, patient information is confidential. Customers who want to be examined and treated by endoscopic kidney stone technique can directly go to Vinmec Health System nationwide or contact the hotline HERE.

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