Because of technology, open surgery for the removal of kidney stones is relatively uncommon. Modern equipment and procedures, such as percutaneous surgery, use x-ray imaging, guide wires and tubes to remove kidney stones. Percutaneous means through the skin. Nephrolithotomy is a surgical cut into the kidney.

P.C.N.L. is performed to remove stones that are causing a blockage or to treat ongoing symptoms such as pain and recurrent infection. Recovery time after surgery is much shorter as no large open incisions need to be made unless complications of surgery arise such as excessive bleeding or equipment failure which are rare.