DOI: https://doi.org/10.36347/sasjs.2026.v12i04.013

Pages: 317-321

Percutaneous nephrolithotomy (PCNL) has undergone significant evolution through miniaturization of instruments and access tracts. This mini review compares the clinical outcomes, safety profiles, and efficacy of mini-PCNL, ultra-mini PCNL, and micro-PCNL techniques. Standard PCNL utilizes 24-30 Fr access sheaths, while miniaturized variants employ progressively smaller tracts: mini-PCNL (14-24 Fr), ultra-mini PCNL (11-13 Fr), and micro-PCNL (4.85-8 Fr). Evidence demonstrates that miniaturized techniques achieve comparable stone-free rates to standard PCNL while offering advantages in reduced blood loss, shorter hospitalization, and lower complication rates. However, these benefits come at the cost of longer operative times. The choice among miniaturized techniques depends on stone characteristics, with mini-PCNL suitable for stones 15-40 mm, ultra-mini PCNL for 10-25 mm stones, and micro-PCNL for stones 15 mm. This review synthesizes current evidence to guide clinical decision-making in the era of minimally invasive stone management.