About Percutaneous Nephrolithotomy (PCNL) For Treating Large Kidney Stones

Percutaneous nephrolithotomy (PCNL) and tubeless PCNL are innovative surgical treatments for patients who have large kidney stones that cannot be treated successfully using SWL (shock wave therapy) or other therapies. PCNL has become the standard surgical treatment for large kidney stones including staghorn stones (stones that fill the kidney).

What is PCNL?

Typically, PCNL is used to remove kidney stones that are larger than 2cm in diameter and cannot be passed through the urinary tract. Percutaneous refers to a minimally invasive surgical technique performed via a small incision through the skin, rather than an open, more invasive procedure. 

 The PCNL Procedure - Step-By-Step


What Makes Dr. Davalos' Approach To PCNL Unique?

Davalos In Surgery1Most surgeons rely on an interventional radiologist to locate the kidney stone(s) and the radiologist then inserts a tube through the patient's skin and into the kidney (the tube is called a nephrostomy tube and drains into a bag outside of the body). Most urologists then use this tube as an entry point into the kidney.  While the tube is often placed in a good location, this is not always the case, and effective stone removal may be limited.  In addition, the patient must go through a separate procedure to have this tube placed and may have to keep the tube in for up to a week before surgery.


Dr. Davalos utilizes a special method to gain his own renal access with precision, utilizing CT imaging and real time fluoroscopy mapping techniques to ensure the most accurate placement of the tube for the most successful removal of the kidney stone. 

The procedure is performed at the same time as the PCNL procedure.  And, a vast majority (>95%) of patients will not need a nephrostomy tube placed at the end of the procedure. This is known as a Tubeless PCNL.

 This precise access, coupled with his surgical experience, results in:

  • The most accurate localization of the stone.
  • Minimal trauma to the kidney and surrounding tissue.
  • Complete stone removal.
  • Fewer post-operative complications, less pain and better recovery following removal of the stone.

Following the procedure, Dr. Davalos takes another image of the kidney to ensure that the stone has been entirely removed and no stone fragments remain. This extra step ensures that his patients are 100% stone free following surgery. 


Get more information:

PCNL Surgery - A Step-By-Step Guide

Learn About Tubeless PCNL

PCNL- What to Expect

Advantages of PCNL Surgery for Large Kidney Stones

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