Percutaneous kidney stone removal, commonly called percutaneous nephrolithotomy or PCNL, is typically used for large, dense, or complex kidney stones that may be difficult to treat through the urinary tract alone. The surgeon creates a small opening in the back and establishes a direct pathway into the kidney. A scope is passed through this pathway so the stone can be seen, fragmented with specialized energy, and removed. This direct access allows larger amounts of stone to be cleared efficiently. A temporary drainage tube, ureteral stent, or catheter may be used afterward while the kidney heals. Follow-up imaging may be performed to check for remaining fragments.