Abstract: Objective：To investigate the efficacy and application of holmium laser lithotripsy with 4.8F visual needle puncture lithotripsy combined with Niaoshitong in the treatment of <1.5cm renal calculi.Methods：A retrospective analysis was made of the clinical data of 43 patients with renal calculi < 1.5cm treated by 4.8F visual needle puncture lithotripsy combined with holmium laser lithotripsy.The observation group received oral urolithotripsy and water 2500ml/day after operation，and the control group received water 2500ml/day after operation.The stonefree rate and stonefree time of the two groups within 3months after operation were compared.Results：There was no significant difference in age，sex and stone size between the two groups（P>0.05）.The stonefree rate of the observation group was 95.5%（21/22）in the first month after operation，compared with 71.4%（15/21）in the control group（P<0.05）.The stones in the observation group were cleared at the second month of reexamination，and 90.5%（19/21）in the second month and 100% in the third month of the control group.There was no statistical difference between the two groups（21/21）.The stone clearance time in the observation group was（1.05±0.21）months，which was shorter than that in the control group（1.38±0.67）months，with statistical significance（P<0.05）.Conclusion：4.8F visual needle puncture lithotripsy combined with holmium laser lithotripsy can effectively comminute kidney stones less than 1.5cm.Urolithotripsy can promote the excretion of residual stones after operation.The combination of the two methods has certain clinical application value.

Key words: integrated nephroscope, holmium laser, renal calculi, Niaoshitong