Q: My 33 years old brother has multiple stones in his right kidney. The left kidney shows normal excretion of the dye with normal pelvicalyceal systems and normal visualized left ureter. The doctor has asked him to go for open surgery, or PCNL procedure. Is it safe?

A:Open surgery for large stone bulk in kidney had been the standard treatment till late eighties when Percutaneous keyhole removal called PCNL has replaced it largely. There is still place for open surgery for stone disease in cases when simultaneous repair of pelvicalyceal system is needed, or when the surgeon is not comfortable. It is most important to have optimal outcome whether obtained by open surgery or via a keyhole.