Feasibility and efficacy of intermediate-supine percutaneous nephrolithotomy: initial experience

Area of Science:

• Urology
• Minimally Invasive Surgery
• Nephrolithiasis Management

Background:

• Renal calculi (kidney stones) pose a significant health challenge.
• Percutaneous nephrolithotomy (PCNL) is a standard treatment, but operative positioning can be complex.
• The intermediate-supine position offers potential advantages in PCNL.

Purpose of the Study:

• To evaluate the feasibility and efficacy of the intermediate-supine PCNL technique.
• To assess outcomes including operative time, hospital stay, and stone-free rates.
• To determine the safety and complication profile of this modified PCNL approach.

Main Methods:

• A modified intermediate-supine position using a saline bag was employed in 15 patients with renal calculi.
• Standard nephrostomy and stone extraction procedures were performed.
• Tubeless PCNL was considered based on surgeon's decision regarding bleeding and injury; retrograde procedures were performed concurrently when needed.

Main Results:

• The mean stone size was 5.48 cm², operative time averaged 78.93 minutes, and hospital stay was 2.60 days.
• Tubeless PCNL was achieved in 86.7% of cases; 73.3% achieved complete stone-free status.
• Complications were low (Clavien-Dindo Grade I and II in one patient each); success rate was 80.0%.

Conclusions:

• Intermediate-supine PCNL is a feasible and effective method for renal calculi treatment.
• The technique demonstrates excellent outcomes, including high stone-free rates and a low complication profile.
• Further prospective studies with larger cohorts are warranted to validate these findings.