Modified Supine Versus Prone Position In Percutaneous Nephrolithotomy

Percutaneous nephrolithotomy for the treatment of renal stones has proved its efficacy and has stood the test of time compared to open stone surgery and shock wave lithotripsy.PCNL has shown a significant evolution during the last 3 decades due to improvements in the access technique, instrumentation, and lithotripsy technology.For many years, the prone position was considered the only position for PCNL. It provides safe access to the kidney with a very low risk of splanchnic injury, a wide surgical field, adequate instrument manipulation, and a good distention of the collecting system. Nevertheless, some potential anesthesiological complications (directly correlated with the position, including circulatory and ventilatory difficulties), especially in obese patients represent the most important disadvantages of the prone position.