Minituriazed percutaneous nephrolithotomy: what does it mean?

A lot of interest has been recently attracted to miniaturized Percutaneous Nephrolithotomy (PCNL). Smaller diameter tracts and instruments, in comparison to standard PCNL are utilized to decrease the morbidity of PCNL. However, a debate is ongoing regarding the safety and efficacy of these methods. The growing enthusiasm toward miniaturized PCNL led to different techniques and instruments, and eventually generated confusion in the terminology of PCNL. In this review, we highlight the different modalities of miniaturized PCNL, their indication, their safety and efficacy, and the appropriate terminology is suggested. A comprehensive review of current literature was performed using PubMed®. Publications relevant to the subject were retrieved and critically appraised. Miniaturized PCNL was introduced with the desire to reduce access-related complications and bleeding. Miniaturized PCNL has yet to prove clear advantage over the standard PCNL. Nevertheless, the current experience proves the safety of the miniaturized techniques. Advantages of the miniaturized PCNL suggested in the literature are the lower bleeding rate and decreased hospital stay. In addition, the miniaturized PCNL has been proven a safe and effective modality of renal stone treatment in pediatric population.