Microperc is a recently described minimally invasive PCNL technique in which percutaneous renal access and lithotripsy are performed in a single step using a 16 G micropuncture needle.
‘Mini-microperc’ is a further technical modification in which an 8 Fr sheath is used to allow insertion of ultrasonic or pneumatic lithoclast probe with suction.
Microperc is currently used to manage single renal calculus or multiple renal calculi, which can be accessed with a single puncture and cumulative diameter of less than 1.5 cm in diameter.
Microperc can provide the high stone clearance rate associated with PCNL without its morbidity that is bleeding due to the use of smaller tract and no dilatation.
The high stone clearance rate and lower complication rate associated with microperc makes it a viable alternative to RIRS since
it is associated with lower risk of ureteric trauma and lower need for prolonged post-operative ureteric stenting.
Microperc offers a particular advantage for difficult to access renal calculi, impacted lower pole calculi with an acute infundibular angle or stones in a calyceal diverticulum, ectopic kidneys, chronic kidney disease and paediatric population.
Length of stay and post operative pain is reduced with a faster recovery compared with standard techniques, primarily due to the totally tubeless technique and smaller incision.
Microperc offers a safe and effective alternative to the standard techniques with reduced complication rates and comparable efficacy.