Mini percutaneous nephrolithotomy in the treatment of renal and upper ureteral stones

PCNL is a well-established treatment option for patients with large and complex renal calculi. In order to decrease morbidity associated with larger instruments like blood loss, postoperative pain and potential renal damage, a modification of the technique of standard PCNL has been developed. This is performed with a miniature endoscope via a small percutaneous tract (11–20 F) and was named as minimally invasive or mini-PCNL. This method was initially described as an alternative percutaneous approach to large renal stones in a pediatric patient population. Furthermore, it has become a treatment option for adults as well, and it is used as a treatment for calculi of various sizes and locations. However, the terminology has not been standardized yet, and the procedure lacks a clear definition. Nevertheless, mini-PCNL can achieve comparable stone-free rates to the conventional method, even for large stones. It is a safe procedure, and no major complications are reported. Although less invasiveness has not been clearly demonstrated so far, mini-PCNL is usually related to less blood loss and shorter hospital stay than the standard method.

In order to decrease morbidity associated with larger instruments like blood loss, postoperative pain and potential renal damage, a modification of the technique of standard PCNL has been developed. This is performed with a miniature endoscope via a small percutaneous tract (11–20 F) and was named as minimally invasive PCNL or mini-PCNL or mini Perc.

CONCLUSION
Mini-PCNL was introduced as an alternative to the standard procedure in order to reduce morbidity associated with larger access tracts. Although less invasiveness has not been clearly demonstrated so far, mini-PCNL is related to less blood loss and shorter hospitalization. It is recommended for treatment of large renal stones in children and can be implemented in adults as well. Mini-PCNL seems to be a reasonable alternative for patients with a small-to-medium-sized stones, especially when a tubeless procedure is considered. Mini-PCNL is safe and is not related to serious complications.

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