Percutaneous Nephrolithotomy (PCNL) is a procedure used to remove large or complex kidney stones that can’t be treated effectively with other methods like ESWL or URS. It involves making a small incision in the back and inserting a thin tube directly into the kidney to break up and remove the stones. PCNL is usually done under general anesthesia and is highly effective for stones larger than 2 cm, staghorn stones, or stones resistant to other treatments. While it’s more invasive than other procedures, it typically removes the entire stone in a single session. A temporary tube (nephrostomy) may be left in place to help drain urine during recovery.