Management of calyceal calculi has changed dramatically during the pas
t 20 years. Minimally invasive techniques virtually have replaced open
surgical stone removal. Even large and complex calyceal calculi may b
e treated effectively with these minimally invasive techniques. Althou
gh open surgical stone removal is preformed infrequently, a clear unde
rstanding of the subtle renal anatomy aids the urologist in more effec
tively treating patients with calyceal calculi and in limiting surgica
l complications.