Urolithiasis is a common disease in urology, with an incidence rate of more than 4% and a 5-year recurrence rate of up to 50%, requiring repeated treatment and posing a serious health threat. At present, according to the statistics of China Stone Disease Control Center, the number of people suffering from stone disease is gradually increasing and is obviously on the rise, the prevalence rate has reached about 10% of the total number of people in China, while in recent years to the younger development, the prevalence rate of 20 to 45 years old is 3 to 5 times that of other people, its harm is second only to cardiovascular disease, malignant tumor, diabetes, becoming the fourth largest killer of human health. The southern region of China is one of the regions with high prevalence of kidney stones in the world. Yibin City is a high incidence area of stone disease, our department treats more than 2,000 patients annually, about 1,000 patients with stones, accounting for about 50% of the annual patient admissions, and about 850 patients with stones need surgery. For a long time, the traditional stone treatment method is “open stone extraction”, which requires a large incision of 10-20 cm in the lumbar area, cutting open the muscles of the lumbar area, 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, a surgical scar is left on the waist after surgery, which is not only unattractive to the skin, but also affects the patient’s physical strength more after surgery. Due to the high recurrence rate of stones, repeated open surgery led to more difficult surgery, more intraoperative bleeding, and sometimes even nephrectomy was required. In 1984, Professor Wu Kaijun of Guangzhou Medical College took the lead in introducing percutaneous nephrolithotomy for stone extraction (PCNL) into China. Compared with open surgery, percutaneous nephrolithotomy has the advantages of less injury, less pain, complete stone extraction and faster recovery. The incision in the lumbar region is usually less than 1cm, and because no muscle is cut, it not only does not affect the aesthetics, but also has almost no effect on the labor force after the surgery, and the stone recurrence can still be repeatedly treated by PCNL. In the early days, the application of percutaneous nephrological technique was limited and could not be promoted due to the expensive surgical equipment and difficult to master technique. Since 2001, our hospital has been the first to introduce German WOLF percutaneous nephrolithoscope and Swiss EMS pneumatic ballistic lithotripter to carry out PCNL in the province, providing a new choice of minimally invasive treatment for patients with stone disease.PCNL requires stone localization, and stone localization methods include X-ray localization and ultrasound localization. It is well known that long-term X-ray exposure can cause damage to the body. With the introduction of Holmium laser and PCNL positioning ultrasound, more than 98% of our patients can be treated with PCNL and discharged from the hospital without the harm caused by X-ray irradiation. What kind of stones are suitable for PCNL treatment? Percutaneous nephrolithotomy is indicated for: all kidney stones requiring open surgical intervention, including complete and incomplete deerstalker stones; ≥2cm kidney stones; symptomatic calcium stones, stones that are difficult to crush by extracorporeal lithotripsy and have failed treatment, or kidney stones under 2cm with significant hydronephrosis, ureteral stones above lumbar 4 vertebrae in the upper ureter, with heavy obstruction or >15mm in length, or ureteral stones due to Ureteral stones with polyp encapsulation and tortuous ureter, where extracorporeal lithotripsy is ineffective or where ureteroscopic treatment has failed. 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 from the heart; it requires very delicate surgical techniques to avoid bleeding as much as possible, to try to remove the stone, and to protect the kidney function. The procedure requires individualized treatment, which means that the location, size and composition of the stone are determined by the location of the channel, the size of the channel and the appropriate lithotripsy tool. Improper channel selection may increase the risk of bleeding, complications and stone remnants. This requires very standardized treatment protocols and delicate operating techniques.