Open surgery to remove stones: When and how?

Abstract

In the age of shock wave lithotripsy and endoscopic stone therapy (percutaneous nephrolithotomy and retrograde [flexible] ureterorenoscopy), open stone surgery is only rarely performed and the indications are limited to a very low number of selected cases. In centers offering all stone treatment modalities, open stone removing procedures constitute around 1-5% of all procedures. However, despite that most situations can be handled by minimally invasive treatment, open stone surgery is still mandatory in special cases. It is therefore absolutely necessary that the skills of open stone removing procedures do not completely fall into oblivion. This chapter reviews current indications for open stone surgery and gives an overview on the applied techniques. © 2011 Springer-Verlag London Limited.