Kidney Stones - Prevention

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Open Surgery (Nephrolithotomy)

Open surgery involves incisions through the patient's flank and into the kidney. The kidneys are cooled down using ice. X-rays are used during the procedure to locate specific areas and the stone. The arteries in the kidney are identified and isolated away from the surgical region. The surgeon locates the collecting system and retrieves the stone. If the surgeon finds any blockage, this is corrected. The surgery is very invasive and is now restricted to the following candidates:

• Patients with very large or complex stones that cannot be removed using less invasive measures
• Very obese patients

Some centers report success with lithotripsy, however, in this patient group, so even these patients should discuss other options with their surgeon.

The procedure is not appropriate for patients with:

• Bleeding or clotting disorders
• Untreated widespread infection
• Severe and chronic kidney insufficiency (unless removing the stone will improve kidney function)

Review Date: 05/22/2006
Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital