New (kidney) stone age

Doctor at Mercy Regional uses tiny hole in back to solve painful problem

Dr. Jeffrey Jones joined Mercy Regional Medical Center in 2010, after 12 years keeping tabs on NASA astronauts and their kidneys. While in space, astronauts can be more susceptible to kidney stones. Jones uses a less-invasive procedure to remove stones. He just makes a small hole in a person’s back and kidney to remove stones. Before, incisions had to be made on the front side and then the kidney was cut open. Enlarge photo

Durango Herald file

Dr. Jeffrey Jones joined Mercy Regional Medical Center in 2010, after 12 years keeping tabs on NASA astronauts and their kidneys. While in space, astronauts can be more susceptible to kidney stones. Jones uses a less-invasive procedure to remove stones. He just makes a small hole in a person’s back and kidney to remove stones. Before, incisions had to be made on the front side and then the kidney was cut open.

Kidney stones that require surgery are no fun, but modern techniques make their removal more bearable and require less down time for the patient, a Durango urologic surgeon says.

“The old way was to make an incision in the front side and then split the kidney,” Dr. Jeffrey Jones said. “We’d remove the massive stone, then put the kidney back together.”

The new procedure, which he does about once a month, requires only a small incision. The stone is pulverized and the pieces can be sucked out through a tube. The patient has a small scar and generally is back to full strength quickly or within days.

Jones, who joined Mercy Regional Medical Center in 2010, put his knowledge to work for 12 years at NASA, where he kept an eye on the health of 100 astronauts who flew in space shuttles or conducted research aboard the International Space Station.

Kidney stones were among the concerns for the space travelers because of loss of calcium from the bone which leaked into their urine, because of exposure to microgravity (near weightlessness) in space, Jones said.

On Earth, about 10 percent of the population – twice as many men as women (13 percent to 7 percent) – will have a bout with kidney stones in their life.

But certain regions of the world, so-called “stone belts,” have rates as high as almost 20 percent, Jones said.

“It’s rare to see kidney stones in children,” Jones said. “But obesity or a diet with a high intake of meat can lead to kidney stones, and we are beginning to see more kids with stones in recent years because of changes in diet and activity among young folks.”

The cause of kidney stones

A kidney stone is a mass of insoluble calcium, uric acid, magnesium ammonium phosphate or cystine compounds that forms in the kidney or urinary tract. They form in response to dehydration, too many minerals in the urine, chronic infection or as a result of gout or other metabolic conditions, Jones said.

Small stones pass with discomfort but on their own, Jones said. Larger stones that lodge in the kidney or urinary tract require medical attention.

Kidney stones are as old as humans, having been found in Egyptian mummies. In the Middle Ages, bloodletting was used in the belief that it could relieve pain.

Many world leaders have suffered from kidney stones, among them Lyndon Johnson, Benjamin Franklin, Napoleon, Peter the Great and Louis XIV, Jones said.

In the U.S., external shock treatment was introduced in the 1980s to break up kidney stones noninvasively, meaning without entering the body, Jones said.

High-energy pressure waves, up to 120 pulses per minute, are applied through a body of water – a water-filled cushion placed over the kidney or in a tub of water.

Kidney stones smaller than 1 centimeter in diameter can be fragmented with shock waves. Slightly larger stones can be smashed if a coiled stent is introduced between the kidney and the bladder beforehand.

Today, some patients who need kidney surgery are candidates for the minimally invasive procedure he uses, Jones said.

It’s called percutaneous nephrolithomy, a longer way of explaining the removal of a stone through a small keyhole in the skin.

In the procedure, a small opening is made in the back. A tube is passed into the kidney that will be the conduit for a camera and instruments.

The surgeon removes medium-sized stones directly or, in the case of a very large stone, he crushes them with ultrasonic waves (up to 3,500 vibrations per minute) or a laser prior to removal.

daler@durangoherald.com

A tube is inserted through the body and kidney wall as shown in this graphic. A device that breaks up large stones in the kidney is inserted through the tube. Then the pieces are extracted from the kidney through the tube. Enlarge photo

Courtesy of Mercy Regional Medical Center

A tube is inserted through the body and kidney wall as shown in this graphic. A device that breaks up large stones in the kidney is inserted through the tube. Then the pieces are extracted from the kidney through the tube.

Dr. Jeffrey Jones once worked for NASA, which saw regular problems with astronauts’ kidneys. Now Jones toils in Durango, where he is keeping up with the newest kidney procedures. Enlarge photo

Courtesy of Mercy Regional Medical Center

Dr. Jeffrey Jones once worked for NASA, which saw regular problems with astronauts’ kidneys. Now Jones toils in Durango, where he is keeping up with the newest kidney procedures.