Laser and surgical technology advancements have rekindled interest in the miniaturization of percutaneous nephrolithotomy (PCNL). The study discusses the various techniques and data on the efficacy of mini-PCNL. Mini-PCNL refers to a group of methods for treating renal stones that use tract diameters ranging from 4.8 to 22 F. The most popular technology uses irrigation to remove stones from the sheath in a passive manner. Active suction is used in the Supermini-PCNL. The tract is reduced to smaller diameters using ultra- and micro-techniques. The primary lithotripsy methodology is laser fragmentation. Studies show a link between lower problems, shorter hospital stays, and a higher tubeless rate. Longer operational durations are a disadvantage, and stone-free rates for bigger stones may be suboptimal.
Mini-PCNL has the benefit of causing less trauma and avoiding the need for nephrostomy tubes. In some cases, ambulatory surgery is a viable option. Laser lithotripsy and active suction advancements have the potential to increase stone removal and treat bigger stones.
Reference: https://link.springer.com/article/10.1007/s11934-021-01042-0
