Advances in puncture localization techniques for percutaneous nephrolithotomy

doi:10.3877/cma.j.issn.1674-3253.2026.05.016

Abstract

Abstract:

Objective

Percutaneous nephrolithotomy (PCNL) is the main treatment for large renal calculi (>2 cm), and puncture localization is the key to surgical success. This article reviews the research progress of puncture localization techniques in PCNL to provide strategies for improving PCNL surgical skills.

Methods

A systematic literature search was conducted across databases including PubMed, Web of Science, and CNKI. The principles, advantages, limitations, and clinical utility of both conventional (fluoroscopy, ultrasound, CT-guidance) and emerging (augmented reality, electromagnetic tracking, robotic assistance, three-dimensional visualization) localization techniques were analyzed.

Results

Novel imaging-guided techniques, such as robot-assisted, augmented reality, CT-ultrasound fusion, and electromagnetic tracking, have shown significant advantages in improving localization accuracy, reducing surgical difficulty, shortening the learning curve, and decreasing radiation exposure.

Conclusion

Key future directions include stereoscopic imaging, radiation dose reduction, image quality optimization, and multimodal image fusion. The integration of artificial intelligence with medical imaging technologies holds promise for further shortening the learning curve and reducing procedural complexity, which is crucial for the broader adoption of PCNL.

Key words: Percutaneous nephrolithotomy, Image-guided navigation, Augmented reality, CT-ultrasound-fusion, Robot-assisted surgery, Three-dimensional visualization

Yongshun Li, Fanfan Li, Juan Chang, Xiaochun Yang. Advances in puncture localization techniques for percutaneous nephrolithotomy[J]. Chinese Journal of Endourology(Electronic Edition), 2026, 20(05): 594-600.

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