Italy: A recent single-center study published in theWorld Journal of Urologyhas highlighted the potential benefits of vacuum-assisted mini-percutaneous nephrolithotomy (vamPCNL) over the standard vacuum-cleanermini-percutaneous nephrolithotomy(vcmPCNL) in reducing infectious complications in patients with low risk factors. The research, conducted by Marco Nizzardo and colleagues from the Department of Urology, Fondazione IRCCS Ca’ Granda–Ospedale Maggiore Policlinico, Milan, Italy, focused on evaluating outcomes in individuals undergoing theseminimally invasive proceduresforkidney stones. The retrospective analysis included data from 229 patients treated between January 2016 and September 2024. All participants met the criteria for low risk, which included a negative preoperative urine culture, absence of prior urinary tract infections or immune disorders, no indwelling stent or catheter before surgery, and undergoing a single-stage procedure. Patient demographics, stone characteristics, and operative parameters were compared between the two surgical techniques to determine their impact on postoperative infection rates. Based on the study, the researchers reported the following findings: The authors emphasize that although both vamPCNL and vcmPCNL are effective minimally invasive techniques for managing kidney stones, the study suggests a clear advantage of vacuum-assisted approaches in minimizing infection risks in low-risk individuals. By facilitating continuous suction during stone removal, vamPCNL may help reduce bacterial load and maintain a cleaner surgical field, which could account for its lower complication rate. The researchers conclude that in low-risk patients, approximately one in ten may still develop infectious complications following mini-percutaneous nephrolithotomy. However, selecting vamPCNL over the conventional vacuum-cleaner technique appears to significantly lower this risk. They highlight the importance of considering stone burden, operative time, and patient gender when assessing infection risk and planning the surgical approach. "Further prospective and multicenter studies are needed to validate these findings and explore whether the benefits of vamPCNL extend to higher-risk populations. The study provides valuable evidence supporting the role of vacuum-assisted techniques in optimizing safety outcomes in kidney stone surgery," the authors wrote. Nizzardo, M., Li Puma, A., Graps, G. et al. Vacuum-assisted mini-percutaneous nephrolithotomy is associated with lower rates of infectious complications compared to standard procedures in low-risk patients: a single-center experience. World J Urol 43, 457 (2025). https://doi.org/10.1007/s00345-025-05783-2