Everything about Nephroscopy, a simple treatment for the kidneys

Are you also afraid of having to undergo a major operation to remove kidney stones? Did you know that instead of having to undergo major surgeries like the ones that used to require major incisions, you can now remove kidney stones using a camera inserted through a small incision? That's what we call a modern treatment method called 'Nephroscopy.' Today, we'll talk about this in detail and very simply.

What is Nephroscopy?

Simply put, this is a procedure used to examine the inside of your kidneys and treat certain conditions. It doesn't involve as much cutting as it used to.

This is done using a special, thin instrument called a nephroscope. It is a long tube, slightly thicker than a pencil. A very small incision is made in the skin on your back, and this tube is inserted into the kidney. Inside this tube is a light, a camera (like a telescope), and an irrigation system to wash the area where the surgery is being performed. The doctor performs the treatment by viewing the images from this camera on a large screen.

Imagine that you need to remove a kidney stone. You can use ultrasound or laser light to break up the stone through this nephroscope. After breaking it up, the pieces are pulled out through this tube. The biggest advantage of this is that you don't have to do a major open surgery like you used to. So you can recover faster.

What are the uses of Nephroscopy?

This treatment method is mainly used for several situations. Let's see what they are.

How should I prepare for this surgery?

There are several things you need to prepare for before undergoing this type of treatment.

• Tests: A urine test will be done to check for an infection in your urine. If there is an infection, you will need to take antibiotics.
• Medication Information: If you are taking blood thinners such as aspirin or warfarin (Coumadin®), you should definitely tell your doctor. He or she will advise you to stop taking these medications about a week before surgery.
• Food and Drink: You generally cannot eat or drink anything for 8 hours before surgery.
• Medical advice: The most important thing is to talk to your doctor about all of this and follow his or her instructions exactly.

How is the surgery done?

Okay, now let's see what the steps are for this treatment.

First, your doctor will carefully review any scans you have had (such as a CT scan or urogram) and plan your surgery. You will be given general anesthesia, so you will not feel any pain, as if you were asleep.

You will then be placed on the operating table with your stomach facing down. First, a small tube (catheter) will be inserted through your urethra into your kidney. A special dye will be passed through the tube and an X-ray will be taken to see the inside of your kidney clearly.

Then, as planned, a needle is inserted through the skin on your back into the kidney. The area is made slightly wider, and a tube (sheath) is inserted. This is done through a small incision about the size of a dime. Now, through this tube, the nephroscope and other surgical instruments can be passed directly into the kidney.

Now, the doctor looks through the camera and breaks up a kidney stone, or if it's an obstruction, removes it, and takes out the pieces through the nephroscope.

Finally, something called a ureteral stent is placed inside the tube that runs from the kidney to the bladder (ureter). This is a hollow plastic tube about 10-12 inches long. This helps urine flow more easily and helps the kidney heal faster. The stent is usually removed when you see your doctor in about a week.

What are the things you need to take care of after going home?

After the surgery, you will be taken to a recovery room. Once everything is confirmed to be fine, you will usually be able to go home the next day. Take special care of these things after you go home.

• If you develop a fever, feel cold and shivery, or have severe pain that cannot be controlled by the painkillers prescribed by your doctor, call your doctor immediately.
• It's normal to have a little blood in your urine after surgery. But...

• Unless your doctor advises otherwise, avoid lifting weights or doing strenuous exercise for two to four weeks.

What are the benefits and risks of this treatment?

The biggest advantage of this is that it is a very safe method and does not require major surgery (traditional surgery). Therefore, the recovery time is shorter and the risk of infection is also lower.

However, like any surgery, there may be some minor risks.

• Bleeding during or after surgery (blood transfusion may be necessary at such times).
• Fluid accumulation in the lungs.
• A serious infection such as sepsis.
• Urinary tract infection.
• Damage to the kidney or urinary tract.

These risks are very rare. Your doctor will explain all of this to you thoroughly before the surgery, so there is nothing to worry about.

Nephroscopy, Kidney Stones, PCNL, Kidney Surgery, Percutaneous Nephrolithotomy, Kidney Stones Sinhala, Inserting a camera into the kidney