China is a region with a high prevalence of urolithiasis, and kidney and ureteral stones are common and frequent diseases in urology, which can easily cause fluid accumulation, infection, bleeding, kidney function damage or even cancer if not treated effectively and timely, and seriously threaten health and life. The current treatment methods include drugs, extracorporeal shock wave lithotripsy (commonly known as “lithotripsy”), open surgery (commonly known as “open surgery”) and minimally invasive endoscopic surgery, which has emerged in recent years. Drug treatment is only suitable for patients with stones less than 6 mm in diameter without obvious fluid accumulation or infection and some special stones with clear metabolic etiology, while relatively simple kidney and ureteral stones can be crushed by extracorporeal shock wave lithotripsy, and complex kidney and ureteral stones can only be removed by open surgery, which is traumatic and slow to recover after surgery. The incidence of residual stones after surgery is high. Percutaneous nephrolithotomy is a minimally invasive treatment method to remove stones with the help of lithotriptic instruments under the nephrolithoscope, which is the preferred treatment for complicated kidney and ureteral stones. Almost all patients with complex renal and ureteral stones can be treated satisfactorily with this method. In the past, percutaneous nephrolithotomy in China mostly used microchannels of 5-6 mm in diameter for skin access to the kidney, and the lithotripsy instruments were mostly pneumatic ballistic or holmium laser. The operation is very risky. At present, our department adopts the standard channel (channel diameter 8mm) percutaneous nephrolithotomy under the guidance of ultrasound, and the lithotripsy instrument is the most advanced fourth generation pneumatic ballistic combined ultrasonic lithotripsy system (the only one in Wenzhou), which has high efficiency of lithotripsy and stone removal in one, while lithotripsy removes the stone fragments by negative pressure attraction, with a wide surgical field of view, ensuring low pressure in the kidney to avoid It has the advantages of small trauma, short operation time, high safety and stone removal rate, low pain, and fast recovery after operation. This technique is suitable for almost all kidney stones that previously required open surgery, such as antler-shaped stones, huge kidney stones, kidney stones that are difficult to be crushed by extracorporeal shock wave or failed to be treated, and also for upper ureteral stones with heavy obstruction or large stones, where extracorporeal lithotripsy is ineffective or ureteroscopy fails, and for kidney stones in obese patients, kidney stones in patients with severe kyphosis or scoliosis deformity, and recurrent stones after surgery, which are difficult It can show its special superiority for patients who are difficult or even impossible to perform open surgery. (The picture above shows the post-surgical incision)