Percutaneous ultrasonic lithotripsy.

Percutaneous removal of upper urinary tract calculi is a well established procedure. Whereas extraction techniques are effective for small calculi, larger or impacted stones require fragmentation before removal. Percutaneous ultrasonic lithotripsy, endoscopically guided removal of fragments through a percutaneous track, is becoming a widely used method for removal of symptomatic renal and upper ureteral calculi. Radiologic involvement in this method has been essential to its application and success. Experience with over 800 procedures is briefly described, and the highlights of the technique are illustrated.