Percutaneous nephrolithotomy made easier: a practical guide, tips and tricks


Raymond Ko, PO Box 167, Enfield 2136, NSW, Australia. e-mail:


Percutaneous nephrolithotomy (PCNL) plays an integral role in managing large renal stones. Establishing percutaneous renal access is the most crucial step in the procedure and requires a thorough understanding of renal, retroperitoneal and thoracic anatomy to minimize the risk of complications. Moreover, access to fluoroscopy and the proper equipment are critical to ensuring complete stone removal. In this review we describe the technique of PCNL used in a high-volume endourology centre, where the urologist is involved in all aspects of the procedure.