Percutaneous removal of kidney stones

The percutaneous approach to the kidney has rapidly gained acceptance since procedures utilizing this approach may be carried out with only local anesthesia at negligible risk to the patient. Percutaneous nephrostomies and the insertion of ureteral stents in patients with malignant ureteral obstructions are now well-established procedures. In recent years, sporadic reports of the percutaneous removal of retained urinary stones have appeared. In this article, various techniques of percutaneous stone removal, as performed at our institutions, will be discussed. The field is too new, and the number of cases too small, to draw firm conclusions as to the preferred approach; in some cases, more than one will have to be tried.