Lithotomy

Lithotomy surgery refers to a surgical procedure that involves the removal of stones (calculi) from organs like the bladder, kidney, or urinary tract. Historically, this term was most commonly associated with the removal of bladder stones, but it can also refer to procedures dealing with kidney or ureteral stones.

Key Points about Lithotomy Surgery:

1. Types of Lithotomy Surgery:

   • Vesical Lithotomy: Removal of bladder stones.
   • Nephrolithotomy: Removal of kidney stones.
   • Ureterolithotomy: Removal of stones from the ureters.

2. Historical Context:

   • Lithotomy has ancient origins, with techniques dating back to as early as 600 B.C. The procedures were often risky due to the lack of anesthesia and proper surgical techniques. In modern medicine, the procedure has evolved significantly.

3. Surgical Techniques:

   • Open Surgery: The traditional approach involves making an incision to access and remove the stones. This is rarely done today due to the invasiveness and risk of complications.
   • Percutaneous Nephrolithotomy (PCNL): A minimally invasive procedure where a small incision is made in the back, and a nephroscope is used to remove kidney stones.
   • Ureteroscopy: A scope is passed through the urethra and bladder into the ureter to remove stones.
   • Endoscopic Lithotomy: A modern approach where endoscopic tools are used to remove the stones with minimal invasiveness.

4. Lithotomy Position:

   • The term “lithotomy” also refers to the position a patient is placed in during some surgical procedures. The lithotomy position involves the patient lying on their back with their legs raised and supported in stirrups, commonly used for urological, gynecological, and some colorectal surgeries.

5. Modern Alternatives:

   • Today, most cases of kidney or urinary stones are treated with non-invasive or minimally invasive techniques such as extracorporeal shock wave lithotripsy (ESWL), where shock waves are used to break stones into smaller pieces that can be passed naturally.

6. Risks and Complications:

   • As with any surgery, lithotomy carries risks such as bleeding, infection, damage to surrounding tissues, and complications related to anesthesia.