Direct kidney inspection (percutaneous nephrolithotomy, PNL)

The renal pelvis or calyx is punctured and expanded. After inserting the instrument, the stone is processed locally using various methods (pneumatic hammer, ultrasound, or laser), and the debris is removed directly. The advantage is that even larger masses of stone can be processed and removed. The most important complication is intraoperative or postoperative haemorrhaging.