Calyceal diverticular stones and residual fragments post PCNL and ESWL are the difficult stones; various modalities have been employed by the urologists like RIRS, redo- PCNL etc. But we have started treating these stones with micro PCNL with tiny puncture and almost no complications. We did Micro PCNL in eight cases.
It was done with 4.3 Fr nephroscope. Initial puncture and dilatation was done till 8 Fr and with Holmium 30 W energy stone pulverization is done. A 6 Fr feeding tube is kept in the tract for 24 hours and then it is removed and the patient is discharged after 24-36 hours.