Written by Shirin

Published On : April 22, 2026 | Last Updated On : April 22, 2026

April 22, 2026

Percutaneous Nephrolithotomy (PCNL) for Large Kidney Stones: What You Need to Know

For patients dealing with “staghorn” calculi or kidney stones larger than 2 centimeters, traditional treatments like shock wave lithotripsy (ESWL) are often ineffective. These larger, complex stones require a more definitive surgical approach. At Miami Robotic Surgery, Dr. Shirin Razdan utilizes Percutaneous Nephrolithotomy (PCNL), the gold standard for removing large and irregularly shaped kidney stones with high success rates.

As a specialist in endourology and minimally invasive surgery, Dr. Razdan focuses on achieving a “stone-free” status while minimizing recovery time and physical discomfort.

What is PCNL?

Unlike ureteroscopy, which enters through the natural urinary tract, PCNL is a minimally invasive procedure where the surgeon gains direct access to the kidney through a small incision in the back.

The Procedure: Under general anesthesia, Dr. Razdan creates a narrow tract (about the width of a pencil) directly into the kidney.
Fragmentation: Using an ultrasonic or laser lithotriptor, the large stone is broken into manageable fragments.
Active Removal: Unlike ESWL, where you must wait to pass stone “dust,” PCNL allows Dr. Razdan to physically remove the fragments during the surgery, ensuring immediate clearance of the obstruction.

When is PCNL the Right Choice?

Dr. Shirin Razdan typically recommends PCNL for patients who meet the following criteria:

Large Stone Size: Stones greater than 2 cm in diameter.
Staghorn Calculi: Complex stones that branch out and fill the internal collecting system of the kidney.
Failed Previous Treatments: When shock wave therapy or ureteroscopy has failed to clear the stone.
Stone Location: Stones located in the lower pole of the kidney that are difficult to reach or fragment with other methods.

The Recovery and “Stone-Free” Advantage

One of the primary benefits of choosing PCNL at Miami Robotic Surgery is the exceptionally high stone-clearance rate, which typically ranges from 87% to over 95% for complex cases.

Hospital Stay: Most patients spend one night in the hospital for observation and are discharged the following morning.
Faster Relief: Because the stone is physically removed, the intense pain and pressure associated with large kidney stones are relieved almost immediately.
Minimal Scarring: The incision is roughly 1 cm in length, requiring minimal suturing and resulting in very little visible scarring.

Why Choose Dr. Shirin Razdan for PCNL?

Dr. Razdan’s background at the Icahn School of Medicine at Mount Sinai in New York City provided her with elite training in endourology. She is recognized as one of the best kidney surgeons in Florida for her ability to handle complex stone disease with precision.

Every treatment at Miami Robotic Surgery is personalized. Dr. Razdan uses advanced metabolic testing to not only remove the current stones but also to develop a preventative plan (including diet and medication) to ensure you remain stone-free in the future.

Frequently Asked Questions

How long does the PCNL procedure take?

The surgery typically lasts between 1 and 2 hours, depending on the size and complexity of the stone.

Will I have a tube in my back after surgery?

In many cases, Dr. Razdan can perform a “tubeless” PCNL, which eliminates the need for an external drainage tube, further reducing post-operative discomfort.

When can I return to work?

Most patients can return to light activity and office work within 5 to 7 days. Strenuous exercise or heavy lifting should be avoided for approximately two weeks.

Reclaim Your Quality of Life from Painful Kidney Stones

Don’t let a large kidney stone compromise your renal health. Consult with a surgeon who specializes in the most advanced clearance techniques available today.

Contact Dr. Shirin Razdan: