Priyank Salecha ¹, Naveen Chandra Acharya ² ,Vamsi Krishna ³

¹ DNB Resident, ^2,3 Consultant Urologist, Department of Urology,Yashoda Hospital,Somajiguda,Hyderabad,Telangana,India

Address for correspondence: Dr Priyank Salecha, DNB Resident, Yashoda Hospital,Somajiguda,Hyderabad,Telangana,India

Email: p.salecha.ps@gmail.com

Objectives: To assess the feasibility of performing percutaneous nephrolithotomy (PCNL) with the patient supine. Although PCNL with the patient prone is the standard technique for treating large (>2 cm) renal stones including staghorn stones, we evaluated the safety and efficacy of supine PCNL for managing large renal stones(upto 2.5cm), with special attention to evaluating the complications.

Materials and Methods :In a prospective study between March 2015 and March 2016 , 60 patients with large renal stones underwent cystoscopy with a ureteric catheter inserted, followed by puncture of the collecting system while they were supine. Tract dilatation to 24 F was followed by nephroscopy, stone disintegration using pneumatic lithotripsy, and retrieval using a stone forceps. All patients had a nephrostomy tube placed at the end of the procedure.

Results :The median (range) operative duration was 120 (90–210) min, and the mean (SD) volume of irrigant was 18.2 (3.7) L. One puncture/two punctures were used to enter the collecting system and clearance was considered with fragments <5mm.We achieved total clearance in 54 out of 60 patients (90%).

Conclusion : Supine PCNL is technically feasible; it has several advantages to patients, urologists and anaesthesiologists. It gives stone-free rates and a low incidence of organ injury comparable to those in standard prone PCNL.

Keywords :Percutaneous, nephrolithotomy, supine position