A state-of-the-art new treatment for kidney stones

Written by: Mr Andrew Ballaro
Published: | Updated: 05/06/2023
Edited by: Conor Lynch

A new technique for the removal of kidney stones is now being used in the UK at select hospitals. The ultra-mini percutaneous nephrolithotomy (UMP/ultra-mini PCNL) is a minimally invasive technique which can be used to treat large, complex, or multiple stones.

 

Consultant urologist, Mr Andrew Ballaro, now regularly performs the procedure both in his NHS and private practice as a day-case procedure. Here he explains how the procedure is performed, and what benefits it can bring to the patient.  

 

What is ultra-mini PCNL?

Ultra-mini percutaneous nephrolithotomy (UMP) was developed in India and has recently been brought to the UK. Developed using new technology, and with patient recovery time in mind, it involves the insertion of a fine tube into the kidney through a 3mm incision in the skin of the back.

 

A laser is then used to fragment the stone, and the fragments are washed out through the tube using a special irrigation system. This enables even quite large kidney stones to be removed safely, completely, and efficiently without needing to dilate the ureter (tube draining urine from the kidney to the bladder) or to leave a ureteric stent, which can be very uncomfortable. 

 

What are the benefits of ultra-mini PCNL?

There are many benefits of ultra-mini PCNL. They include the following: 

  • Ultra-mini PCNL significantly reduces blood loss (meaning there is less need of blood transfusion), the risk of damaging kidney blood vessels, and the post-operative length of stay compared to standard procedures.
  • UMP avoids the need for uncomfortable ureteric stents (a thin tube inserted into the ureter to prevent or help treat obstruction of urine flow).
  • There is less recovery time with this procedure; Mr Ballaro performs the UMP as a day-case procedure. 
  • People go back to normal activity quicker compared to other surgical techniques used to extract kidney stones.

 

Who is a candidate for the ultra-mini PCNL procedure?

Any patient with a significant sized kidney stone is an ideal candidate. The procedure may be recommended in those who have large kidney stones, especially in the ureter, or kidney stones which block more than one branch of the collecting duct system in the kidney.

 

You can book an appointment to discuss the UMP/ultra-mini PCNL procedure with Mr Andrew Ballaro by visiting his Top Doctors profile. 

By Mr Andrew Ballaro
Urology

Mr Andrew Ballaro is a highly regarded consultant urologist in North London and Essex with over 15 years of experience. He specialises in the management of all urological problems including blood in urine, urinary infections, prostate pain syndromes, general prostate and bladder disease, and the diagnosis of urological cancers including the investigation of raised PSA with MRI Fusion prostate biopsy.

He has specialist surgical expertise in the management of kidney stone disease and benign prostate enlargement (BPE), and consistently publishes UK leading surgical outcomes for complex stone operations. He offers a choice of surgical procedures for benign prostatic enlargement tailored to the patient’s requirements including Holmium Laser prostatectomy (HOLEP) and is highly experienced in dealing with very large prostates and urinary retention, with every patient in a large series going home the day after surgery without a catheter.

Mr Ballaro takes satisfaction in providing second opinions, and is supported by a warm, skilled and responsive managerial team. Together they aim to provide the best possible outcome for each and every patient. Mr Ballaro's extensive training began after graduating from The Royal Free Hospital Medical School in London, and undertaking his surgical training at Oxford. He was awarded a fellowship from the Royal College of Surgeons of London and went on to complete higher urological training on the North London Training Scheme. This was followed by advanced training in complex stone surgery from national and international experts in his field.

Alongside his dedication to education, he is currently teaching trainees at the London Deanery, catering to various levels of expertise. Additionally, he has been honoured with a Hunterian Professorship from the Royal College of Surgeons of England, showcasing his commitment to scholarly pursuits. Holding a master’s degree in urology and an MD in clinical sciences from the Institute of Urology, Mr. Ballaro has extensively published research on bladder physiology and minimally invasive urological surgery. He is the co-author of the latest edition of the popular medical student textbook 'Lecture Notes in Urology'.

 

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