Kidney Stones - Prevention

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Open Surgery (Nephrolithotomy)

Open surgery involves incisions through the patient's flank and into the kidney. The surgeon will cool the kidneys using ice. X-rays during the procedure help locate the stone. The surgeon will isolate the arteries supplying the kidneys to ensure they are not harmed during the surgery. The surgeon will then locate and remove the stone. The surgeon will also correct any blockage in the affected area. The surgery, called nephrolithotomy, is very invasive and therefore is only used for:

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

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Some centers report success with extracorporeal shock wave lithotripsy in patients who would normally be nephrolithotomy candidates. Therefore, 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: 06/08/2010
Reviewed By: Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).