Patient positioning during percutaneous nephrolithotomy: what is the current best practice?

Panagiotis Mourmouris, Marinos Berdempes, Titos Markopoulos, Lazaros Lazarou, Lazaros Tzelves, Andreas Skolarikos Second Department of Urology, Athens Medical School, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Athens, Greece Abstract: Percutaneous nephrolithotomy (PCNL) is the gold standard procedure for treatment of large stones and complex kidney disorders, but its morbidity remains the highest among stone treatment procedures. In pursuit of minimizing complication rates, surgeons have developed different variations of the classic prone position in which PCNL is usually performed; one among them is supine position. In this study, we review the literature and present all available evidence on different variations in positioning during PCNL, in an effort to identify if there is a position that can minimize the morbidity of this procedure. Keywords: percutaneous nephrolithotomy, prone, supine, complications