Lithotomy

Lithotomy

File:Lithotomy Nefrolit.jpg

Illustration of a lithotomy procedure

Lithotomy is a surgical procedure for the removal of kidney stones (calculi) from the urinary tract. The term "lithotomy" is derived from the Greek words "lithos" meaning "stone" and "tomos" meaning "cut". This procedure has been practiced since ancient times and has evolved significantly with advancements in medical technology.

History

The practice of lithotomy dates back to ancient civilizations, including the Greeks and Romans, who developed early techniques for stone removal. The procedure was historically performed without anesthesia, making it extremely painful and risky. The development of anesthesia and antiseptic techniques in the 19th century greatly improved the safety and efficacy of lithotomy.

Procedure

Lithotomy involves making an incision in the lower abdomen or perineum to access the bladder or ureters, where stones are located. The stones are then removed manually or with the aid of surgical instruments. Modern techniques may involve the use of endoscopy or laparoscopy to minimize invasiveness.

Positioning

The patient is typically placed in the lithotomy position, which involves lying on the back with the legs flexed and supported in stirrups. This position provides optimal access to the pelvic region for the surgeon.

Techniques

Several techniques can be employed during a lithotomy, including:

• Open lithotomy: Traditional method involving a large incision.
• Endoscopic lithotomy: Utilizes an endoscope to remove stones with minimal incisions.
• Percutaneous nephrolithotomy (PCNL): Involves a small incision in the back to access the kidney directly.

Complications

As with any surgical procedure, lithotomy carries potential risks and complications, such as:

• Infection
• Bleeding
• Injury to surrounding organs
• Recurrence of stones

Modern Alternatives

Advancements in medical technology have introduced less invasive alternatives to traditional lithotomy, such as:

• Extracorporeal shock wave lithotripsy (ESWL): Uses shock waves to break stones into smaller pieces that can be passed naturally.
• Ureteroscopy: Involves the use of a ureteroscope to remove stones from the ureter or kidney.

Related pages

• Kidney stone
• Urology
• Endoscopy
• Laparoscopy