Hamamoto S, et al. – In this study, the clinical feasibility of a new navigation procedure for percutaneous renal puncture using real–time virtual sonography (RVS) during endoscopic combined intrarenal surgery (ECIRS) was investigated. According to the results, real–time virtual sonography–guided renal puncture was found to be feasible, with a lower incidence of bleeding–related complications compared to US–guided puncture.