الفهرس 
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Abstract
PCNL is the gold standard for the management of large and complex renal stones. Despite being first described nearly 2 decades ago, mini-PCNL has yet to gain widespread acceptance, and its place within the armamentarium of renal stone surgery. Training of the urologist to gain the needed experience is crucial to achieve good outcomes. Standardizing complications by using the modified Clavien classification facilitates reliable comparison of PCNL outcomes. The miniaturization of PCNL-instruments appears to result in a safer procedure without compromising effectiveness. In particular, mini-PCNL is an effective and safe procedure for management of renal stones of any size with low morbidity, good success rate and reasonable operative time. Moreover, it offers a reliable treatment option in obese patients, as well as in patients with previous renal operations. Mini-PCNL has a high primary stone free rate. BMI, Stone burden and number of tracts are independent factors that determine the outcomes of mini-PCNL. With one auxiliary procedure, mini-PCNL reaches a high success rate approaching 95%. The procedure is safe in patients with solitary kidneys and those with chronic renal disease without deterioration of the renal function. Although mini-PCNL has comparable outcomes to conventional PCNL, further well-designed, randomized studies are needed to better evaluate the use of various currently available miniaturized PCNL techniques, before considering them as standard procedures in the management of renal stone. Training of the urologist to gain the needed experience is crucial to achieve good operative results. The application of stone morphometry scoring systems may help better prediction of postoperative outcomes, however this is yet to be further investigated. Standardized reporting of complications facilitates reliable comparison of the outcomes.