Ureteroscopic techniques have been increasingly used in the treatment of urological stones, especially kidney stones. For intrarenal stones, the efficiency of ESWL is significantly lower than that of PCNL, and for small stones, the difficulty of localization under X-ray and the need to constantly change focus to ensure minimal damage to the kidney limit the use of ESWL in kidney stones. For kidney stones with a diameter of 2 cm and stones >1 cm in the lower renal calyces, PCNL can achieve a clearance rate of 86%-100%. RIRS is a “revolutionary” advancement in the treatment of intrarenal stones, which can achieve a 100% clearance rate for some specific types of stones by crushing and removing stones through the normal physiological channels of the body using intracavitary lithotripsy technology. Compared with PCNL, RIRS greatly reduces the risk of postoperative complications and improves perioperative safety. With the continuous advancement of ureteroscopic techniques and tools, together with Holmium laser lithotripsy equipment, we have been able to lithotripsy almost all parts of the intrarenal collecting system. The literature shows that the angle between the infrarenal calyx and the renal pelvis, the surface area of the pelvic calyx system, and the width of the calyx neck can affect the lithotripsy rate, and that preoperative urography can predict the ease and effectiveness of the procedure. RIRS not only provides a comprehensive view of the distribution of stones in the renal collecting system, but also allows the use of holmium laser to crush the stones and remove them completely in combination with the mesh basket, avoiding the obstacle of stone evacuation due to the abnormal structure of the renal calyces. In patients with combined urinary tract infection, RIRS may lead to intraoperative infection dissemination and increase the probability of postoperative sepsis. Pre- and postoperative antibiotic therapy can be given, and intraoperative tachyphylaxis and dexamethasone can be given to reduce the chance of mucosal edema and infection. At the same time, delivering the flexible delivery sheath as far as possible to the pelvic-ureteral junction not only helps the ureteral flexible scope enter the renal collecting system safely and quickly, but also reduces intraoperative pelvic perfusion pressure, decreases the incidence of infection, and facilitates the intraoperative removal of larger stones. The delivery sheath is left as high as possible without significant resistance so that the distal end of the delivery sheath reaches the pelvic-ureteral junction. In approximately 10% of patients, a flexible delivery sheath cannot be left in place because of the thin lumen of the ureter, and forcing the sheath in can result in damage or tearing of the ureteral wall. The ureter is observed through an 8/9.8F ureteral rigidoscope prior to placement of the flexible delivery sheath. For patients in whom the rigid scope cannot be upstaged, attempting to leave a ureteral stent tube in place improves the success rate of access. Studies have shown that preoperative placement of a double J tube can reduce the risk of ureteral injury by as much as seven times compared to patients who do not have one. However, intraoperative placement of a flexible ureteroscope sheath will always produce some shearing force throughout the ureter, with the possibility of ureteral mucosa detachment in mild cases and ureteral avulsion in severe cases. Sometimes this injury is difficult to be detected intraoperatively. There is no uniform standard for grading the extent of the resulting ureteral injury at home and abroad, and there are no reports on the chance of postoperative distant ureteral stenosis and atresia. Although preoperative retention of a double J tube can lead to back discomfort and urinary tract infection in patients. However, this may significantly increase the success rate of the procedure and potentially reduce the probability of ureteral injury in patients.