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Pyelolithotomy

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Open surgery for renal calculi is generally reserved for:

  • large staghorn calculi
  • stones refractory to ESWL or percutaneous nephrolithotomy
  • correction of anatomical abnormalities that predispose to stone formation
  • underlying medical conditions preventing lengthy procedures

Pyelolithotomy is the removal of a stone via the renal pelvis. The kidney is exposed with a postero-lateral incision over the 12th rib.

Nephrolithotomy is the removal of a stone through the renal substance. It is generally used to pick out the calyceal fragments of large staghorns following pyelolithotomy. To prevent extensive bleeding from the renal parenchyma, the renal artery is dissected out and clamped.

Residual fragments can by disintegrated by ESWL.

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