Percutaneous nephrolithotomy Percutaneous nephrolithotomy literally means to create a channel to the kidney through skin puncture, through which the nephrolithoscope is inserted into the kidney and the kidney stones are broken and removed using laser, ultrasound, liquid electricity and other lithotripsy tools. This is called “eye lithotripsy”. Percutaneous nephrolithotomy is a modern minimally invasive technique for kidney stone treatment, which was carried out at Yuhuangding Hospital around 2003. For patients: for kidney stones over 2cm, kidney stones under 2cm that are not effective with extracorporeal lithotripsy or with significant hydronephrosis, and some upper ureteral stones. Technical difficulty Percutaneous nephrolithotomy is a very technical procedure. As we know, the kidney is a very vascular organ, and the blood flow in the kidney accounts for 1/4 of the bleeding volume of the heart, and the puncture procedure requires a very delicate surgical technique to avoid bleeding as much as possible, to try to remove the stones, and to protect the kidney function. To some extent, this surgery is much more difficult than radical nephrectomy for kidney cancer. Many hospitals have strict rules on the admission system of percutaneous nephrolithoscopy. Minimally invasive advantages 1. Small incision: The traditional method of “open incision for stone extraction” requires a large incision of about 20cm in the waist, cutting open the muscles of the waist, separating the kidney, and making a small incision in the renal pelvis or renal parenchyma to remove the stone. This method is highly invasive, bleeds more, is painful and has a slow recovery. It usually requires about 7 days of hospitalization after the surgery. Because of the large surgical incision, not only is the skin unsightly, but the patient’s physical strength is more affected after the surgery. Compared with open surgery, percutaneous nephrolithotomy has the advantages of less injury, less pain, complete stone extraction, and faster recovery. The incision in the waist is usually less than 1cm and does not cut through the muscle, so it does not affect the aesthetics. 2. Fast recovery: Traditional open surgery is not only unattractive to the skin because of the large surgical incision, but also because many muscles are cut off during the operation, which leads to frequent postoperative muscle paralysis and local sensory numbness, and the physical strength of the patient is more affected after the surgery. There is almost no effect on labor force after surgery. After surgery, patients are usually discharged from the hospital in 2~3 days and can resume normal physical work after 1 month. 3.Little impact: Compared with open stone extraction, percutaneous nephrolithotomy does not need to cut open the kidney, so it has little impact on the kidney and surrounding structures, and does not affect various kidney surgeries in the future, and also has less impact on kidney function. 4. Good effect: Since our hospital carried out percutaneous nephrolithotomy, we have summarized the treatment experience of more than 2000 patients, and the overall stone removal rate reached 81%, the removal rate of single stones in the renal pelvis or single calyces reached 99%, the removal rate of complex stones in the first stage of surgery reached 65%, and the removal rate in the second stage of surgery reached 87%. He has also accumulated rich experience in the treatment of young children’s stones, isolated kidney stones, horseshoe kidney stones, antler-shaped kidney stones, multiple stones and stones, spongy kidney stones, transplanted kidney stones, ectopic kidney stones, calyx stones, recurrent stones after open surgery, urinary stones after urinary diversion, and larger stones larger than 3 cm in diameter. In the course of clinical practice, he has handled many difficult patients including cardiac insufficiency, poor lung function, severe obesity, advanced age, paraplegia, spinal hip lesions, coagulation disorders, and severe infections.