Instrumentation and Surgical Technique

Percutaneous nephrolithotomy has been traditionally performed in a prone position. Since the description of supine percutaneous access by Valdevia, interest in supine positioning for percutaneous nephrolithotomy is ever increasing. Supine PCNL is a viable alternative for management of renal calculi in a subgroup of patients with urolithiasis which include simultaneous renal and ureteric calculi, high-risk, and obese patients. Supine percutaneous nephrolithotomy can also be offered in situations such as in ectopic kidney or fused ectopic kidneys. Supine percutaneous nephrolithotomy remains a option for stones in allograft recipients. In this chapter we discuss the indications for and technique of supine percutaneous nephrolithotomy.