Mini Percutaneous Nephrolithotomy | MedStar Health

Kidney Stone Surgery and Tubeless Mini Percutaneous Nephrolithotomy (Mini PCNL)

Same-day surgery for large kidney stones

Kidney stones can form in the urinary tract when chemical compounds crystalize in the urine. Sometimes the stones are too large to pass on their own. In cases where the stones are especially large or difficult to reach, one of the most effective treatment options is through kidney stone surgery using a procedure called Percutaneous Nephrolithotomy (PCNL).

At MedStar Health, we specialize in performing PCNLs. In addition, we’re one of the few programs in the Washington, D.C., metropolitan area that can perform these procedures in an outpatient setting. By performing same-day tubeless mini percutaneous nephrolithotomy (mini PCNL), our team of providers are able to remove kidney stones through smaller incisions than a standard PCNL. As a result, patients experience less pain and quicker recovery times, allowing our patients to return home on the same day of the procedure and avoid the placement of painful nephrostomy tubes after surgery.

Why choose us

As one of the only centers in the Mid-Atlantic region offering tubeless surgery to remove kidney stones, our urologists perform a high volume of mini PCNLs every year. Because we have extensive experience using this approach, we’re able to treat the most complicated cases, such as those involving large or multiple kidney stones. We’re honored to be a referral center for many other urologists in the DC metro area, treating patients who have found other procedures to be ineffective.

Working as a team, we take a comprehensive, individualized approach to determining the right kidney stone treatment for each patient. We work closely with a variety of other specialists to plan kidney stone surgery, including nephrologists and interventional radiologists, when appropriate. Most importantly, we also work diligently to prevent kidney stone recurrence, collaborating with dietitians and primary care providers to help lower our patients’ risk for kidney stones in the future.


Benefits of a tubeless mini PCNL

Standard PCNLs require the placement of a nephrostomy tube in the back, often requiring a multi-day inpatient hospital stay. In contrast, our urologists can perform a mini PCNL using smaller incisions and instruments, eliminating the need for a tube before and after surgery. As a result, patients can expect:

  • Fewer risks of complications
  • Less pain and discomfort
  • Less bleeding
  • To go home on the same day of the surgery
  • Faster return to work, hobbies, and other daily activities

What to expect during a tubeless mini PCNL

Before kidney stone surgery, your care team will provide instructions about how to prepare. This may include guidelines for when to stop eating or drinking, when to stop taking certain medications, and when to arrive for surgery.

Then, you’ll arrive at the hospital on the day of your surgery. During a mini PCNL, our experienced urologists will begin by making a small incision in the skin while you are under general anesthesia. Through this incision, a small camera is inserted into the kidney and a specialized instrument is passed through the incision to the kidney to break up the stones and remove the stone fragments from the body.

Recovery from kidney stone surgery

After a mini PCNL, most patients will return home the same day with minimal pain. Unlike a standard PCNL, our patients will not need a nephrostomy tube for urine drainage. Therefore, patients can expect quicker, smoother healing and fewer risks of complications. Your doctor will provide specific instructions to aid in your recovery, such as avoiding heavy lifting for a week following surgery.

Once we’ve removed the kidney stones, we analyze them to determine what it is made of. We also follow up with our patients, conducting metabolic analysis to understand the potential cause of your kidney stone. This information helps us to develop a prevention plan to minimize your risk of stone recurrence in the future.

Frequently asked questions

  • How is a mini PCNL different from standard kidney stone surgery?

    The main difference between a standard and a mini PCNL is the size of the opening. The mini PCNL involves the use of smaller instruments and smaller incisions. A smaller incision allows us to perform the procedure without leaving a tube in the back after the surgery. It also facilitates a better recovery, less pain, and post-operative discomfort. As a result, our patients can go home the day of the procedure.

  • How is mini PCNL different from other same-day kidney stone removal treatments?

    There are several different surgical options available to remove large or complex kidney stones. Your urologist will evaluate your stone size and composition, overall health, symptoms, and other factors to determine the approach that would be best for you. Other same-day procedures include shock wave lithotripsy and ureteroscopy, which involve passing special instruments through the urethra to break down and/or remove stone fragments without the need for incisions. In contrast, a mini PCNL requires a tiny incision through which your urologist will insert special instruments to directly access the kidney.

  • Who is a candidate for surgical kidney stone removal?

    A mini PCNL is typically used to remove intermediate and large kidney stones if non-surgical treatments have been ineffective. Most patients who are candidates for a standard PCNL are also candidates for a mini PCNL, the less invasive approach. Patients who have small kidney stones may be candidates for other kidney stone treatments, such as shock wave lithotripsy or ureteroscopy.

    Learn more about other kidney stone treatments

Our locations

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MedStar Health: Urology at Chevy Chase

5530 Wisconsin Ave.
Ste. 950
Chevy Chase, MD 20815

MedStar Health: Urology at Lafayette Centre

1133 21st St., NW
Building 2
Floor 6
Washington, D.C., 20036

MedStar Health: Urology at MedStar Georgetown University Hospital

3800 Reservoir Road, NW
Pasquerilla Healthcare Center
3rd Floor
Washington, DC 20007

MedStar Health: Urology at MedStar Washington Hospital Center

106 Irving St., NW
Physicians Office Building (POB)
Ste. 315
Washington, D.C., 20010