This is a process to break kidney stones without surgery. Also called ESWL or Extra Corporeal Shockwave Lithotripsy. In other words shockwaves generated outside the body are focused on the stone in the kidney via a liquid medium usually water to break the stones to tiny particles which then pass out of the urinary tract with the flow of urine. Modern machines like ours do not require anaesthesia for lithotripsy.
Commonly the shockwaves are generated by spark gap, electromagnetic or piezoelectric crystals and focused by a parabolic reflector on to the stone. The energy passed on to the stones makes it expand and fragment with minimum effect on the kidney tissue.
Stones upto 2cm which are in a suitable anatomic position can be fragmented. Usually if the stone bulk is considered larger or if more than one session is required the DJ Stent, that is a fine tube with holes, is placed under anaesthesia to prevent any blockage to the flow of urine on the treatment side. This remains inside between the kidney and the bladder till the treatment is completed. It is then removed as a daycare.
Lithotripsy unit is based in our North Nazimabad campus.
For larger size kidney stones or stones in unfavorable anatomic locations of the Per Cutaneous Nephro Lithotomy or Keyhole surgery is done. Small less than an inch hole is made in the skin and with the help of endoscopes and Pneumatic/Ultrasound/Laser lithotripters the stone is fragmented and fragments taken out at the same time. This is done under anaesthesia. Occasionally for larger stones more than one holes may be made or additional ESWL lithotripsy may be required.
For Ureteric stones UreteroRenoScopy with Pneumatic/Ultrasound/Laser lithotripsy is done to fragment the stones into tiny fragments which may be removed or allowed to pass with the urine flow. Like in ESWL a DJ Stent may be used which is later removed as a daycare procedure.
Large complicated stones may be removed by open surgery.