Introduction: In order to better control renal pelvic pressure (RPP), reduce surgical complications and increase operative efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL), we designed an MPCNL with intelligent monitoring and control of RPP and sought to explore its clinical efficacy and characteristics. Subject and Methods: This study included 60 patients with renal staghorn calculi. A 5F ureteral catheter was connected to an invasive blood pressure monitor for monitoring and control of RPP. A 12F renoscope was inserted through a percutaneous tract for lithotripsy using a laser, with the help of an intelligent system to monitor RPP continuously, which includes an irrigation and suctioning platform and an integrated intraluminal pressure sensory PCNL suctioning sheath. Before the lithotripsy, intraluminal pressure control value and perfusion flow were set on the platform. Results: RPP was maintained at a range of - 12 to 2 mm Hg. The mean operative time was 120 min. The mean intraoperative bleeding amount was 100 ml. Fifty-two of the 60 patients the stones were cleared by one surgery. Conclusions: In our suctioning MPCNL with the intelligent control of RPP, the intraoperative RPP could be accurately controlled within the preset safety range. The stone clearance rate was high. (C) 2016 S. Karger AG, Basel