[Percutaneous nephrolithotomy (PCNL): Conditions for a safe performance.].

Objective: To describe the PCNL technique addressing those conditions that enable us to perform the procedure with maximum patient's safety without losing focus on the objective of lithiasis resolution.

Methods: Based on our experience, accumulated with time, and the constant update of the endourological techniques we treat those issues in relation to PCNL from the efficiency, efficacy and effectiveness perspective. To consider them involves the successful performance of the technique, with complications prevention and taking cost-efficiency into account. The first one is in close connection to selection of the most adequate technique for each case, training and team work to achieve excellence. With meticulous preoperative preparation and procedure performance, on every single step of the operation, we will ensure an effective technique, avoiding complications. Efficiency comes from the two first and involves, in addition to perform a successful and safe procedure, that the procedure should be cost effective from the management point of view.

Conclusions: PCNL offers the possibility of endoscopic extraction of renal lithiasis, regardless of its volume, density or site, but its success, safety and efficiency are closely linked to the possibility of establishment of an appropriate tract that enables manipulation and total extraction of the calculus.