From PCNL to Mini-PCNL
Percutaneous nephrolithotomy (PCNL) is the gold-standard treatment for managing renal stones larger than 2 cm, offering superior stone-free rates compared to other modalities like ESWL or URS. However, its relative invasiveness is associated with risks such as postoperative fever (10–16%), sepsis (2%), bleeding (8%), and the need for blood transfusion (3–6%). To minimize the complications associated with standard PCNL, the mini-PCNL technique was developed, based on the refinement and reduction of the percutaneous sheath size (less or equal to 22 fr).
Moreover, innovations such as improved laser systems, smaller-caliber sheaths, and high-resolution nephroscopes with optimized irrigation have further elevated its precision and clinical outcomes.
Redefining Mini-PCNL: The First-Generation SMP
Dr. Zeng and his team have advanced mini-PCNL beyond traditional methods by developing the first-generation Super-Mini-PCNL (SMP) system in 2016 to overcome limitations seen in smaller tract procedures. Unlike other miniaturized techniques, SMP integrates a 7 Fr nephroscope with enhanced irrigation and a modified 10-14 Fr sheaths featuring continuous negative pressure aspiration.
His development of the first-generation Super-Mini-PCNL has set a new benchmark in safety and efficiency. By enabling active suction of fragments, enhanced irrigation, and consistently low intrarenal pressure, SMP allows for effective stone removal with minimal bleeding and reduced risk of sepsis, even in pediatric and complex cases.
Performance: The New-Generation SMP
Dr. Zeng and his team have continued refine the miniPCNL technique with new generation of SMP. The eSMP (enhanced SMP) integrates a combination of a 12 Fr mini‑nephroscope with an 18 Fr sheath, optimizing the balance between irrigation inflow and outflow to enhance suction, maintain low intrarenal pressures, and enable extraction of larger stone fragments.
Through these continuous innovations, Dr. Zeng’s team confirms its strong commitment to advancing mini-PCNL and consolidates its position as a global leader in this field.