PCNL instruments are a combination of access tools, an optical system, energy sources for stone fragmentation and imaging, and each part has to match the others. This guide lists the PCNL procedure equipment an operating room team needs, from needle and dilators to nephroscope, lithotripter, forceps and C-arm, and shows how to plan the set so that nothing is missing on the first day.
PCNL procedure and why the set is complex
In percutaneous nephrolithotomy a tract is created from the skin into the renal collecting system, usually under fluoroscopic guidance, and the stone is fragmented and removed through a sheath. The procedure is staged: puncture, dilation, sheath placement, stone treatment, drainage. Each stage has its own instruments.
Because the stages involve different suppliers and categories, procurement lists tend to leave gaps. A structured checklist reduces the risk. For a comparison with the endoscopic route, see PCNL vs RIRS.
Access and dilation instruments
PCNL access techniques start with a puncture needle, a guidewire and a safety wire, followed by dilation with sequential dilators, a balloon or a one-step system, and finally an access sheath. The sheath sizes define the PCNL category: standard, mini or ultra-mini, which also decides the nephroscope you need.
Check that dilators, sheaths and nephroscope are from a compatible range, with the same sheath internal diameter, and that the sealing cap and irrigation connections fit. We discuss size choice in nephroscope sizes and mini-PCNL.
- Puncture needle, guidewire and safety wire
- Sequential or balloon dilators
- Access sheath in the sizes of your programme
- Sealing cap and irrigation connections
Nephroscope, graspers and fragmentation tools
The nephroscope is the optical core of the set; it is a rigid scope with an offset or straight eyepiece, a working channel and, in many models, a separate irrigation port. Its working channel accepts a nephroscope grasper, PCNL forceps, a basket or a laser fiber. See what is a nephroscope for the basics.
For fragmentation a holmium laser such as the MegaPulse 70+ is commonly used; it is a 70 W holmium:YAG with Lithotripsy mode and Expert mode, controlled from a 12-inch touch screen. Ultrasonic and pneumatic devices are other categories; our lithotripter types guide describes them. Ask the supplier for PCNL forceps and graspers specification, since the price of forceps is a lifetime item in a busy programme.
Imaging, C-arm and irrigation
Fluoroscopy guides puncture and checks residual fragments, so a mobile C-arm is part of the PCNL set. The Perlove PLX C22 is a mobile C-arm with 9 or 12 inch flat panel detectors, a 5 kW generator at 110 kHz, focal spots of 0.3 and 0.6 mm and a touchscreen. Its dual micro-focus tube design and metal artifact suppression help in orthopedics-type and stone workflows alike.
Irrigation is the second dependency: choose pump or gravity systems with pressure control, and a collection system to keep the surgical field clear. Camera and monitor must be sized for the room. A Richard Wolf imaging set is described on the Richard Wolf brand page.
Putting the set together
List instruments by stage and confirm per stage what is on the shelf, what is single-use and what is reprocessed. Define the quantity of sets according to case volume and reprocessing turnaround, because PCNL instruments are delicate. Provide a spare telescope when possible.
Beckfinity can prepare a complete PCNL equipment plan with installation and training through the installation service. Send your programme details via the contact page for a quote.
Frequently asked questions
What instruments are needed for PCNL?
Access (needle, wires, dilators, sheath), a nephroscope, graspers or forceps, a lithotripsy device, irrigation, imaging with a C-arm and a drainage set.
Which laser is used in PCNL?
Holmium lasers such as MegaPulse 70+ are widely used; ultrasonic and pneumatic devices are alternatives.
Do I need a C-arm for PCNL?
Fluoroscopic guidance is commonly used for puncture and residual stone checks; many programmes use a mobile C-arm.
How are PCNL forceps chosen?
By compatibility with the nephroscope channel, jaw type and durability; ask for the specification and reprocessing guidance.
Can one supplier provide the whole set?
Beckfinity can coordinate the equipment plan and sourcing; confirm the exact items for each programme.
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