Long time result with lithotripsy (ESWL) are not good so with advanced research latest technologies like RIRS and Mini-Micro PCNL are available for treatment of kidney stones. There is no result in hard stone and ureteric stone with ESWL. With the advent of RIRS all hard stones are treated successfully with holmium laser. In RIRS two technologies are essential one is fiber optic very thin endoscopic technology and holmium laser technology.
For hard kidney stone of upto 1.5 cm size flexible thin nephro ureteroscope is passed from urethra through bladder, ureter and finally into kidney. From the channel of flexible ureteroscope laser fiber is passed and stone is made into the dust. In Micro-mini PCNL small incision is made on the back of the patients. With the help of X-ray Imaging kidney is punctured and track is dilated upto 12 F with the help of mini nephroscope stone is visualized and made into the dust.