Flexible renal nephroscopy: Overcoming the difficulties

In 1941, following an open surgery for nephrolithiasis, Rupel and Brown advanced a rigid cystoscope into the kidney through an established drainage tract to remove several obstructing calculi, effectively becoming the first to perform percutaneous nephroscopy. In 1955, the field was further advanced when Goodwin and colleagues reported successful, purposeful percutaneous access into a hydronephrotic kidney. However, it was not until 30 years later that percutaneous nephrostolithotomy (PCNL) would be popularized. Due to its minimally invasive nature, low morbidity, and great efficacy, PCNL has evolved into the gold standard for the treatment of large renal and proximal stones, including staghorn calculi.