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Introduction: Percutaneous nephrolithotomy (PCNL) is widely performed as the preferred treatment for kidney stones larger than 20 mm in pediatric patients, with current research focusing on comparing outcomes between prone and supine positions to determine optimal procedural positioning. Therefore, the aim of this study is to compare the efficacy of prone versus supine positioning in pediatric PCNL, providing clarity on this critical aspect of the procedure to guide clinical decision-making., Methods: We conducted a systematic review in PubMed, Embase, Scopus, Cochrane, Web of Science and Google Scholar. We included studies that compared PCNL in prone vs supine positions for pediatric patients. Our primary outcome was stone-free rate (SFR). Secondary outcomes included operative time, length of hospital stay and overall complications rate. The statistical analysis was performed using Review Manager 5.4., Results: We retrieved 8 articles, with 269 patients in the prone group and 223 patients in the supine group. The mean age of all patients was 7.92 years old. Our findings presented no statistically significant difference in SFR between the two positions (OR 0.67; CI95 0.38, 1.18; p = 0.17; I 2  = 0%). Additionally, we noted a significant reduction in operative time in the supine position group (MD 13.75; CI95 4.35, 23.15; p = 0.004; I 2  = 84%). At the same time, the length of hospital stay after the procedure was lower in supine group (MD 0.61; CI95 0.34, 0.88; p < 0.0001; I 2  = 21%). No difference was observed regarding the total complication rate (OR 1.47; CI95 0.88, 2.47; p = 0.15; I 2  = 0%)., Conclusion: Our meta-analysis suggests that PCNL performed in the prone position is equivalent to supine PCNL in terms of SFR. However, mainly in the RCT studies, we could observe benefits of the supine position in comparison of prone position in terms of lower operative time, as well as a reduced postoperative hospital stay., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable since this work is a systematic review and a meta-analysis. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: The use of pneumoperitoneum is an essential step for performing laparoscopic and robotic surgery. Pneumoperitoneum insufflation can cause complications such as pneumothorax, subcutaneous emphysema, and pneumomediastinum. The purpose of this meta-analysis is to compare the safety of using the conventional insufflation system versus a Valveless insufflation system as devices for manufacturing pneumoperitoneum in robotic-assisted nephrectomy., Methods: A comprehensive literature search was conducted on PUBMED, EMBASE, SCOPUS, and Cochrane, from inception until January 2024. Randomized and nonrandomized prospective studies were included in the meta-analysis, performed by the R+ Rstudio., Results: Three publications encompassing 478 patients were included. We observed no difference in SCE (OR 0.60, CI 95% 0.27;1.34, p = 0.134, I 2  = 0), PNM (OR 0.82, CI 95% 0.24;2.78, p = 0.558, I 2  = 0), When comparing groups conventional insufflation system (CIS) versus AirSealTM insufflation system (AIS) with pneumoperitoneum pressure of 15 mmHg or 12 mmHg., Conclusion: The presented data showed no difference between the AIS when compared with CIS in Pneumoperitoneum insufflation-related complications., (© 2024. The Author(s).)