Editing AUA: Stone Surgery (2016) (section)

=== Open/laparoscopic/robotic surgery ===

* '''Except in cases of coexisting anatomic abnormalities, open/laparoscopic/robotic surgery for upper tract stones should not be routinely performed.'''

* Series in adults have suggested that laparoscopic approaches may compare favorably to percutaneous techniques for large or staghorn renal stones, but in children, these approaches should be considered secondary or tertiary options for treatment of renal or ureteral stones since more conventional procedures, including SWL, URS, and PCNL, have high rates of success and lower risks of serious complications.
* '''The primary exception to this statement is in the pediatric patient with one or more renal or ureteral stones and a co-existing anatomic anomaly, such as UPJ obstruction''', '''UVJ obstruction and duplication anomalies with an obstructed ectopic ureter.''' In such cases, open, laparoscopic, or robotic-assisted laparoscopic surgery is indicated to remove the stone(s) and repair the primary anatomic defect.