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The anatrophic nephrolithotomy described by Smith and Boyce is an excellent method of preserving a maximum number of functioning nephrons by minimizing injuries to both the renal parenchyma and its blood supplies. However, clamping of the main renal artery is inevitable and may damage renal function despite regional hypothermia. We devised a modified technique of nephrolithotomy with selective clamping of the segmental artery and no necessity for regional hypothermia.
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