Percutaneous nephrolithotomy is to create a channel from the skin to the kidney at the waist, through which the nephrolithoscope is inserted into the kidney and the kidney stones are broken and removed using laser, ultrasound and other lithotripsy tools. This is called “perforation and extraction”. Percutaneous nephrolithotomy is a modern and minimally invasive technique for kidney stone treatment, and our urology department took the lead in carrying out this technique in 2003 in southern Henan. I. Indications Percutaneous nephrolithotomy is suitable for: kidney stones over 2cm, kidney stones under 2cm which are invalidated by extracorporeal lithotripsy or accompanied by obvious hydronephrosis, and some ureteral stones in the upper part of the ureter. Advantages Surgical treatment of kidney stones include: open stone extraction, extracorporeal lithotripsy, percutaneous nephrolithotripsy, soft ureteral lithotripsy, etc. The traditional method of “open 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 take out 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 lumbar region is usually less than 1 cm, and because no muscles are cut, it not only does not affect the aesthetics, but also has almost no effect on the labor force after the surgery. The patient is usually discharged from the hospital in 2~3 days after the surgery. Compared with laparoscopic lithotripsy, percutaneous nephrolithotripsy has less impact on the kidney and surrounding structures and does not interfere with various kidney surgeries in the future. Compared with extracorporeal lithotripsy, it has short treatment cycle, immediate effect and less impact on kidney function. Technical characteristics Percutaneous nephrolithotomy is a very technical procedure. As we know, the kidney is a very rich vascular organ, and the blood flow in the kidney accounts for 1/4 of the bleeding volume of the heart, and 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. In some ways, this surgery is much more difficult than nephrectomy for kidney cancer. The procedure requires individualized treatment, which means that the location, size and composition of the stones should be determined according to the patient’s location, number, size and composition of the stones, as well as the size of the channel and the corresponding lithotripsy tools. Improper channel selection may increase the risk of bleeding, complications and stone remnants. This requires very standardized treatment protocols and delicate operating techniques.