The Duke Comprehensive Kidney Center has access to state of the art equipment and cutting edge technology for the treatment of kidney stones.

Treatment options include:

• Shockwave lithotripsy
• Ureteroscopy
• Percutaneous nephrolithotomy
• Robotic or laparoscopic surgery

Shockwave lithotripsy is a minimally invasive option for the management of kidney stones in which the stones are broken into small pieces by a sound wave that passes through the skin and is focused on the stones.

During shockwave lithotripsy you will be placed on a special bed and given medication that will prevent you from feeling significant pain or discomfort. The medicine usually makes you feel very sleepy.

A gel bolster or “pillow” is then placed along the side to be treated. The stones are targeted using either x-rays or ultrasound, and shock waves will be directed into the body to shatter the stone. Once the stones are broken into small pieces, the pieces pass out of the kidney on their own.

It is important to know that not all stones respond well to shockwave treatment. The size of the stone, its location within the urinary tract, and the stone composition all determine whether shockwave lithotripsy will be an appropriate treatment for your individual case.

In most cases, this technique can be performed on an outpatient basis, and you can go home that same day.

Ureteroscopy is a minimally invasive treatment that involves the passage of a small scope through the urethra and bladder up to the kidney stone.

The kidney stone is visualized, and then broken into small pieces using a laser. The pieces can then be pulled out using a basket.

This outpatient procedure is done in the operating room with an anesthetic to ensure that you do not feel any pain or discomfort.

This procedure approaches 100 percent effectiveness for stones passing through the ureter (the tube that connects the kidney to the bladder). Our physicians perform over 300 ureteroscopic surgeries for kidney stones every year.

Percutaneous nephrolithotomy is a minimally invasive surgical option used for larger kidney stones. A small incision (less than one inch) is made in the back and a camera is placed through this hole into the kidney.

The stones are broken into small pieces and the pieces are then removed. At the completion of the surgery, the incision is closed. Patients typically spend one night in the hospital following this procedure.

Percutaneous nephrolithotomy is most the effective treatment for stones greater than 1.5 cm and those that have failed shockwave lithotripsy or ureteroscopy. Duke physicians perform over 150 percutaneous nephrolithotomies every year.

Robotic or laparoscopic surgery may also be used to treat kidney stones. This procedure is typically reserved for large stones in kidneys that are not in their normal position.

Robotic surgery is also highly effective at treating stones in kidneys that are affected by other conditions, such as uretero-pelvic junction (UPJ) obstruction, which is a blockage of the kidney where the ureter connects to the hollow portion of the kidney.

Robotic surgery is performed with four small incisions through which the robotic instruments are placed. After this procedure is completed, patients typically stay in the hospital two days. We perform over 200 robotic surgeries annually at Duke.