الفهرس 
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Abstract
The technique of percutaneous renal surgery has revolutionized the way renal stones are treated. It has become increasingly clear in the last years that a percutaneous approach is optimal for many patients.
The field of endourology has developed rapidly from a multistage to a single staged procedure. Also the morbidity of a percutaneous procedure has decreased because of improvements and modifications of the technique.
Although percutaneous renal surgery offers a lower morbidity compared to that of open renal surgery, nevertheless, there is increasing demand to decrease the morbidity of a percutaneous procedure further by improving and miniaturizing the technologies already existing, thus, making the use of the percutaneous technique feasible for younger age groups. The challenge is to make percutaneous renal surgery truly an outpatient procedure, which would make it more palatable to different age groups of patients as well as more cost effective.
Starting 1999, several reports have challenged the standard use of adult sized PCNL instruments on pediatric patients. Many of these reports confirmed the safety and effectiveness of Miniperc technique for renal stone management in children and went further to show decreased morbidity rates.
In the present series, a total of 42 pediatric patients underwent the Miniperc technique for their renal stones. This technique was applied to cases with multiple stones, branching, complex stones, with different degrees of parenchymal thickness and complex collecting systems.
In the present series, the stone free rate in the Miniperc technique with 14 Fr sheath was about 79%. This incidence of residual stones was related to the pre¬-existing burden, complexity of stones and complexity of the collecting system.
Miniaturized percutaneous renal surgery in pediatric patients is a safe and effective procedure that provides an alternative to the standard percutaneous renal surgery with the same indications, limitations and outcome. It also provides a high patient satisfaction with significant decrease in postoperative analgesia requirements, shorter hospital stay compared to standard PCNL in children. This would have a definitive impact on the overall cost reduction.
So, the Miniperc technique is believed to have several advantages, including decreased blood loss, increased maneuverability, and shorter hospital stays. As the risk for bleeding complications is related to the number and caliber of tracts used, limited transfusion rates have been reported with this technique.