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St. Joseph's Hospital
LIVE WEB CAST ON KIDNEY STONE SURGERY HealthEast performs surgery live on Internet
ST. PAUL, MN. - Surgeons with HealthEast Kidney Stone Institute performed an innovative kidney stone surgery live on the Internet. The surgery at St. Joseph's Hospital in St. Paul, Minnesota will took place on October 25, 2005 at 4:00 pm Central Time.
"We are excited to share our innovative technique with patients and surgeons in this novel approach that offers the opportunity to learn about surgical advances that may benefit their health and to observe it right on their own computer," said Andrew Portis, MD, Medical Director HealthEast Kidney Stone Institute at St Joseph’s Hospital.
Percutaneous nephrolithotomy (PCNL) is performed for clearance of the largest and most complex kidney stones. During the procedure, the doctor makes an incision in the patient’s side about the size of a fingertip. A narrow tunnel (“access tract”) is then created directly into the kidney. A special telescope (called a nephroscope) is used to examine the inside of the kidney. Stones are then broken using ultrasonic or laser lithotripsy.
Traditionally, PCNL involves leaving a nephrostomy tube through the access tract, which remains until complete stone clearance can be confirmed by post- operative imaging. A repeat or “second look” procedure is required in as many as fifty percent of cases. Hospital stay is generally three to four days.
At St. Joseph’s Hospital, patients are offered a more efficient, less morbid procedure. By maximizing intra-op stone detection through a combination of fastidious operative technique and sensitive fluoroscopy, just ten percent of patients require a secondary procedure. With confidence of complete stone clearance, a nephrostomy tube becomes unnecessary. By avoiding the nephrostomy tube the need for pain control medication is cut in half, and the average hospital stay is reduced three fold to just 1. 3 days. At St Joseph’s Hospital, this minimally invasive procedure has been available to ninety percent of complex stone patients regardless of stone burden.
At St Joseph’s Hospital, “tubeless” PCNL is performed as a joint procedure by an urologist and an interventional radiologist and respective support staffs. The surgeon who conducted the procedure was Andrew Portis, MD. Carl Bretzke, MD, provided radiological expertise and actively participated in the entire procedure. This highly effective procedure is the product of ongoing collaboration between Dr. Portis and Dr. Bretzke, who share a desire to continuously enhance their patients’ results and experiences as they deal with complex kidney stone issues.