In the 1980s, the surgical treatment for urinary caliculi in Japan, changed from open surgery, which aims to remove the urinary calculi completely, to extracorporeal shock wave lithotripsy (ESWL), which aims only to crush the stone and the endoscopic procedure which aims mainly to crush and in some cases to remove the stone if possible. The residual stone fragments are considered to be a cause of reccurence, but these new treatments are less invasive. Recently, with the development of endoscopic instruments stone fragments can be removed completely with flexible ureteronephroscopes, thin laser fibers, and fine basket catheters.