Under ultrasound, a 0.5-0.8 cm diameter channel is created through the lumbar skin to the kidney, through which a ureteroscope or nephroscope is placed at the location of the kidney stone and the stone is crushed by holmium laser under direct vision, and then the stone particles are flushed out and removed from the channel. Advantages of the procedure: (1) Unlike traditional open surgery, which requires a 20 cm long incision and no incision of the kidney, this procedure is performed through the established percutaneous renal channel, which is less traumatic than traditional open surgery, with faster recovery and less surgical risk, and leaves only a small scar on the lumbar skin after surgery. (2) Lithotripsy is performed under direct vision, which can remove the maximum number of stones. (3) The high-power holmium laser has the effect of tissue vaporization and cutting, which can simultaneously deal with pelvic ureteral junction stenosis and calyx neck stenosis combined with stones and reduce the recurrence of stones after surgery. (4) Holmium laser can break stones of any composition, with good lithotripsy effect and fast lithotripsy speed, shortening the operation time. (5)For patients who cannot tolerate long time surgery, the operation can be stopped and staged at any time, which improves the safety of the operation. (6) The damage to the kidney is not only smaller than open surgery, but also smaller than repeated multiple extracorporeal lithotripsy. Indications for surgery: (1) All kidney stones requiring open surgical intervention, including complete and incomplete deerstalker stones, ≥2 cm kidney stones, symptomatic calyces or diverticula stones, stones that are difficult to crush by extracorporeal shock wave and those that have failed treatment. (2) Large stones in the upper ureter above L4, with heavy obstruction or length diameter >1.5cm; or ureteral stones due to polyps encapsulation and tortuous ureter, ineffective extracorporeal shock wave or failed ureteral placement. (3) Special types of kidney stones, including pediatric kidney stones with obvious obstruction, kidney stones in obese patients, kidney stones combined with pelvic-ureteral junction obstruction or ureteral stenosis, isolated kidney combined with stone obstruction, horseshoe kidney with stone obstruction, transplanted kidney combined with stone obstruction, and kidney stones without effusion, etc.