Clinically, we often encounter the question, what should we do if we have kidney stones? Do I need surgery? Is surgery better or medication better? What will happen if I don’t deal with kidney stones? In fact, not all kidney stones need to be treated, but there are some cases of kidney stones that must be treated. When the stones are small, it is possible to watch and wait and live peacefully with the stones. In general, 90% of stones less than 0.5 cm in diameter can be discharged naturally, but treatment is now entirely possible through minimally invasive endoluminal interventions: percutaneous nephrolithotomy for stone extraction, which can crush and remove stones using laser and combined pneumatic ballistic/ultrasound lithotriptors. In layman’s terms, this technique involves making a small cigarette-sized hole in the waist through which the stone is reached and then crushed and flushed out of the body, which is less invasive, less painful and has a shorter hospital stay. The other operation is a non-invasive procedure in which the stones are crushed and flushed out with a laser inside the renal pelvis through the natural channels of the urinary system by means of a soft ureteroscopic technique. Generally, the former option is used for large/complex stones, and the latter option is used for small stones. The major difference between the two is that the soft microscope is used to break stones through the ureter to the kidney without a wound, while the percutaneous nephroscope is used to break stones through a small hole in the skin to the kidney, which is not too harmful to the human body, but the soft microscope needs to be discharged by itself after the stone is broken. Nephrolithotomy is more painful and more complete, but there is a risk of bleeding. Therefore, the specific surgery plan should be decided according to the stone size, location, kidney function, previous stone history, etc. Diagram of PCNL surgery Diagram of ureteral soft lithotripsy surgery