What are the surgical management of urinary tract stones?

  Several common procedures are now popularized.  1.Ureteroscopic lithotripsy A rigid ureteroscope is used to reach the stone through the urethra, bladder and ureter; then a lithotripsy instrument is placed through the ureteroscope to break the stone, but there is a certain failure rate of lithotripsy and residual stone rate.  2. Percutaneous perforation nephrolithotomy This method requires a small hole in the patient’s waist (open surgery is to make an incision about 15-20cm long in the waist), then insert the nephrolithoscope into the kidney, find the stone and remove or flush out the stone with stone extraction forceps. This surgical technique has been successfully used in our department to relieve the pain of a large number of patients with kidney stones and ureteral stones. It is highly efficient, but sometimes it is difficult to reach the stones with large angles, and it needs to penetrate the kidney parenchyma, which has the risk of inducing hemorrhage.  3.Ureteroscopic lithotripsy Ureteroscope is the latest surgical method at home and abroad, which can remove both ureteral and renal stones in one operation, although the cost is relatively high. However, the efficiency of lithotripsy is relatively low, and when large stones are encountered, the lithotripsy time is long and increases the risk.  4. Percutaneous nephrolithotomy combined with ureteroscopic lithotripsy combines the advantages of the above two devices, which largely shortens the operation time, reduces the operation risk and decreases the stone residual rate. This technique is recommended when the kidney stones are large.  5.Laparoscopic lithotomy Take 3 to 4 small openings to enter and take the stones with little damage.  6.Open surgery The traditional surgery method is to cut an incision about 15-20cm long in the lumbar area, which is a big surgical injury, slow recovery after surgery, and patients often lose part of their labor force after surgery, and is now less used.