Initial step of PCNL (Percutaneous nephrolithotomy) is cystoscopy and placement of an open ended or ureter catheter on the side of the stone and injecting dye which will give the configuration of the pelvis-calyceal system. The patient is placed in prone position. Proper PCN tract is critical to the success in removing stones. Two important considerations are safety and access. Always use a posterolateral approach. Use middle or inferior calyx for pelvic or upper calyceal stone or direct access to a calyceal diverticulitis stone. Do not make a tract directly into the pelvis but to go through posterior calyx end on so that parenchymal hold helps in maintaining the tract.

PCNL tray gives you a systematic approach to the procedure and gives ease of use to the surgeon and the scrub staff. By arranging all the items needed for the PCNL procedure in one tray and nephroscope in an upper compartment gives a compact space and accountability and discipline.