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Bhandari Hospital & Research Centre

Kidney Stones Treatment

Stone Clinic takes a comprehensive approach not only to treat patients who have stones but also to help patients prevent recurrence. A full time registered dietician works in tandem with urology surgeon in developing kidney stone prevention program for their patients.

Comprehensive Care for The Urinary Stone Diseasas:

Stone disease is a very common problem all over the world. Approximately 60% of stones can be managed by Lithotripsy and rests of stones need various endo-urological procedures to remove the stones without open surgery.
 
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Our services offered are:

My alt textTeam approach to treatment and prevention

Innovative minimally invasive surgery

Comprehensive metabolic evaluation

Patients centered dietary counseling

Latest Techniques Available for Removal of our hospital are :

P.C.N.L. (Per Cutaneous Nephro Lithotripsy)

U.R.S. (Uretro Renoscopy)

Holmium Laser Lithotripsy

E.S.W.L. By Dornier Compact Delta Lithotriptor

E.R.C.P. For Stones in CBD

These surgeries are done routinely by well-experienced surgeons in our hospital. We undertake on an average 250-300 endoscopic surgeries every month for treatment of various kinds of renal and biliary stones. Urinary Stones Overview : Hardened mineral deposits formed in kidney are called kidney stones. When waste materials in the urine do not dissolve completely and the kidney is unable to evacuate them crystals and kidney stones are likely to form. There are many types of stones depending upon the type of mineral deposit.

Reasons of stone formation:

https://www.freepnglogos.com/uploads/arrow-png/green-circle-arrow-picture-29.pngDietary excess consumption of oxalate containing food like dry fruits

Milk,milk products,tomato,tea and coffee

Environmental; Hot and dry climate

Low water intake

High protein intake

Genetic

Lack of inhibitory factors in body

Symptoms of kidney stones:

Pain in lower back radiating to front.

Pain and Burning sensation while urinating.

Increased frequency of urination.

Presence of blood or pus in urine.

Nausea and vomiting.

Fever, chill, loss of appetite.

Treatment

ESWL – Extracorporeal Shock Wave Lithotripsy uses highly focused electromagnetic waves projected from outside the body to crush kidney stones anywhere in the urinary system. The stone is usually reduced to sand-like particles that can be passed in the urine. Large stones may require more than one ESWL session. It can be used for patients of all age groups and those who have heart and breathing problems. Both X-Ray and USG controls are available on this machine. The positioning, focusing, and delivery of shock waves are all controlled by advanced-computerized system with safety cut-offs to prevent damage by human error. Patients need not stay in hospital and can go home the same day.

P.C.N.L. – Percutaneous Nephrolithotomy (PCNL) is the preferred technique for treating large stones (over 2 cm in diameter) within the kidney. It involves keyhole surgery performed through a 1 cm incision in the skin overlying the kidney (see diagram).

What are the Advantages?

Allows large or complicated stones to be treated in a minimally invasive fashion, where in the past this would have necessitated a large skin incision.

Hospital stay is 3-4 days and out of hospital recovery time is significantly shorter than traditional open surgery.

What are the Disadvantages?

Compared to traditional treatments of large complex stones, there are no disadvantages. Improved techniques and equipment have allowed this type of surgery to be safer than ever before.

U.R.S. – Ureteroscopy is where a long thin rigid telescope is introduced into the upper urinary tract via the bladder (see diagram below). The diameter of the instrument is less than 2 mm and allows visualization of the lower half of the ureter. A small instrument port allows introduction of micro-baskets and laser fibers (0.3 mm in diameter) to manipulate and fragment stones. It is used only to treat stones in the ureter, and cannot treat stones within the kidney (see flexible pyeloscopy info sheet for kidney stone treatment).

What are the main Advantages of this Approach?

Allows stone treatment without the need for any incision by using the urethral orifice as the entry point

A highly successful technique (over 95%)

Can be performed as day surgery

What are the main Disadvantages?

More invasive compared to shock wave lithotripsy

Small risk of damaging the ureter (0.5%)

Gall Bladder Stones

Reasons of Stone Formation:

When the concentration of Cholesterol or fats increases in the bile juice it precipitates as stone in the gall bladder. It can occur in all age groups and in both males and females, though more commonly in females. The five ‘F`s’ of Gall Bladder stone diseases are: Fat, Flatulent, Fair, Female of Forty is more likely to have gall stones.

Sighs and Symptoms of Gall Bladder Stones:

Gaseous distension or bloating.

Flatulent dyspepsia.

Acute abdominal pain along with vomiting and fever.

Jaundice - This occurs when a gallstone drops down from the gall bladder into the common bile duct resulting in obstruction to the flow of bile, hence causing jaundice.

Pancreatitis - This occurs when the slipped gallstone in the common bile duct irritates the duct of the pancreas gland leading to inflammation of the gland.

Laparoscopic cholecystectomy is a procedure in which the gallbladder is removed by laparoscopic techniques. Laparoscopic surgery also referred to as minimally invasive surgery describes the performance of surgical procedures with the assistance of a video camera and several thin instruments.

During a laparoscopic surgical procedure small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. The camera and the instruments are then introduced through the ports which allow access to the inside of the patient. The camera transmits an image of the organs inside the abdomen onto a television monitor. The surgeon is not able to see directly into the patient without the traditional large incision. The video camera becomes a surgeon’s eyes in laparoscopy surgery since the surgeon uses the image from the video camera positioned inside the patient’s body to perform the procedure.

Benefits of minimally invasive or laparoscopic procedures include less post operative discomfort since the incisions are much smaller,quicker recovery times,shorter hospital stays,earlier return to full activities and much smaller scars. Furthermore there may be less internal scarring when the procedures are performed in a minimally invasive fashion compared to standard open surgery.

How safe is Laparoscopic Gallbladder Surgery?

Laparoscopic cholecystectomy is a very safe operation. The overall complication rate is less than 2%. The complication rate for laparoscopic gallbladder surgery is similar to the complication rate for traditional open gallbladder surgery when performed by a properly trained surgeon.

How is Laparoscopic Cholecystectomy Performed?

Many thousands of laparoscopic cholecystectomy have been performed in the USA and this operation has an excellent safety record. Some of the important steps in the operation are as follows:

General anesthesia is utilized, so the patient is asleep throughout the procedure.

An incision that is approximately half an inch is made around the umbilicus ( belly button) three other quarter to half inch incisions are made for a total of four incisions. Four narrow tubes called laparoscopic ports are  placed through the tiny incisions for the laparoscopic camera and instruments.

A laparoscope (which is a long thin round instrument with a video lens at its tip) is inserted through the belly button port and connected to a special camera. The laparoscope provides the surgeon with a magnified view of the patient's internal organs on a television screen.

Long specially designed instruments are inserted through the other three ports that allow your surgeon to delicately separate the gallbladder from its attachments to the liver and the bile duct and then remove it through one of the ports from the abdomen.

Your surgeon may occasionally perform an X-ray called a cholangiogram to exam for stones in the bile duct.

After the gallbladder is removed from the abdomen then the small incisions are closed.

First in Laser Technology in Rajasthan:

While providing the latest in Surgical Laser Technology to break up stones. The comprehensive kidney stone clinic emphasizes on prevention by conducting a detailed metabolic evaluation offering dietary counseling and if indicated starting medication.

Where surgical intervention is required we have the latest FDA Approved HOLMIUM LASER as well as DORNIER LITHOTRIPTOR for all kinds of stones.