Which Calyx to Puncture in Pcnl?

So, there are no rules for puncture. However, it is always better to enter via opposite calyx, if the stone is at poles. Pelvic stones are best managed by upper or middle calyx puncture. Lower pole puncture, though seems easy for newcomer, is the most unfriendly in PCNL usually owing to its anterior tilt.

How stone is removed by PCNL?

A tube is placed through the incision into the kidney under x-ray guidance. A small telescope is then passed through the tube in order to visualize the stone, break it up and remove it from the body. If necessary a laser or other device called a lithotripter may be used to break up the stone before it can be removed.

What is the percutaneous puncture?

In surgery, a percutaneous procedure is any medical procedure or method where access to inner organs or other tissue is done via needle-puncture of the skin, rather than by using an "open" approach where inner organs or tissue are exposed (typically with the use of a scalpel).