Advanced Stone Surgey
Ureteroscopy and Laser Lithotripsy
What is it?
Ureteroscopy is a surgery used to treat stones in the ureters (the tubes that carry urine from the kidneys to the bladder) or the kidneys. It's done by using a thin, flexible camera called a ureteroscope, which is inserted into the body through the urethra (the tube that carries urine out of the body) and up into the bladder and ureters.
How it works
Insertion: The surgeon gently inserts the ureteroscope through the urethra to reach the ureters or kidneys. The procedure is done underanesthesia, so you’re asleep during the surgery.
The ureteroscope has a small camera on the tip, so the surgeon can see the inside of the ureters and kidneys on a screen.
If there’s a kidney stone, the surgeon can treat it directly using small tools (ie. a laser to break up the stone, and a basket to remove small pieces) passed through the scope.
Key points:
It’s a minimally invasive procedure, meaning it has no large incisions or cuts.
The procedure is done underanesthesia, so you’re asleep during the surgery.
After the surgery, you usually have a temporary stent placed in the ureter to keep it open while it heals.
Supine Ultrasound Guided Percutaneous Nephrolithotomy
What is it?
Supine Ultrasound-Guided PCNL is a procedure used to remove kidney stones through a minimally invasive approach. The term "supine" means you lie on your back during the procedure, and "ultrasound-guided" means the surgeon uses ultrasound (a type of imaging that uses sound waves) to help guide the treatment.
Dr. Garbens is one of only a few urologists in Canada who offer this innovative technique.
How it works
You are put to sleep with a general anesthetic. The surgery is performed with you on your back (supine position). The surgeon uses ultrasound to locate the kidney stones. The ultrasound helps them see the stones in real-time and plan the best way to reach them, while avoiding other organs (liver, spleen, intestines). After the stones are located, a small incision (cut) is made in your back (2 cm), and a tube is inserted into the kidney to access and remove or break up the stones. Using special tools, the surgeon removes the stones by breaking them into smaller pieces and suctioning them out.
Key points:
It’s a minimally invasive procedure, meaning it requires only a small (3cm) incision.
The surgeon uses ultrasound (no radiation) to guide them precisely to the stones reducing the need for X-rays (radiation). Ultrasound helps guide the surgeon to the exact location of the stones, reducing the risk of damaging surrounding organs.
The procedure is done under general anesthesia, meaning you’ll be asleep and won’t feel anything.
Patients experience less pain and have a quicker recovery compared to more invasive surgeries.
Mini Percutaneous Nephrolithotomy (stentless surgery)
What is it?
Mini PCNL stands for Mini Percutaneous Nephrolithotomy. It’s a procedure used to remove kidney stones that are too large or difficult to pass on their own. “Mini” refers to the fact that it’s a less invasive version of traditional PCNL, as it uses a smaller incision (cut in the skin).
How it works
Small Incision: The surgeon makes a tiny cut (about the size of a pencil tip) in your back to reach the kidney. Dr. Garbens does this usually supine (on your back).
Inserting a Tube: Through this small cut, a thin tube is inserted into the kidney using ultrasound and x-rays. This tube allows the surgeon to see the stone and use special tools to remove or break it up.
Removing the Stone: The surgeon can either remove the stone in pieces or use a laser or other tools to break it into smaller pieces, which are then taken out.
Key points:
It’s a minimally invasive procedure, meaning it involves a small cut and doesn’t require large incisions.
It is done under general anesthesia, so you’ll be asleep during the procedure.
Since it uses a smaller incision than traditional PCNL, it has lower risk of blood loss, injury to kidney and recovery is faster.
As Dr. Garbens goes through the back, she often doesn’t have to leave a stent after the surgery, this means less irritation and discomfort for patients.