A comprehensive service for the management of kidney stones exists at Epsom and St Helier University Hospitals NHS Trust.
The management of urinary stones involves correct investigation limiting radiation exposure, appropriate treatment with modern equipment, specialist expertise in operative intervention and metabolic review in selected cases to prevent long term recurrence.
The lithotripsy unit at Sutton Hospital
The lithotripsy unit at Sutton Hospital is the regional centre for patients locally from Epsom and St Helier hospitals, and also from St.George's, Kingston, Mayday and East Surrey hospitals' urology departments.
The unit has been in existence for over ten years and has developed expertise and a safety record gained by treating hundreds of patients per year. An emergency service exists for suitable patients with acute renal colic to reduce hospital admission and operative intervention.
Flexible ureterorenoscopy and laser lithotripsy
Flexible ureterorenoscopy and laser lithotripsy has developed over the last ten years with the miniaturisation and improved flexibility of endoscopes and development of lasers which can break all types of stone no matter how hard. The flexible scope is passed along the natural urinary pathways directly inside the kidney and the flexibility of the scope allows the laser energy to be applied directly onto the stone to turn it to dust or fragments which can then be removed for analysis if required.
Percutaneous keyhole surgery (PCNL)
This procedure allows large or awkwardly positioned stones to be treated. The operation requires careful planning and experience in order to place an endoscope through the skin and muscle of the body wall directly into the kidney. A combination of ultrasound and x-ray guidance with specialist endoscopic skills is required to make this a safe and very effective treatment. Mr. Gordon submits data prospectively into the national audit on outcomes of this complex surgery.
