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Supine or prone position for mini-PNL procedure: does it matter

Zafer Tokatlı1, Mehmet Ilker Gokce, Evren Süer

  • 1Department of Urology, Doruk Hospital, Ankara, Turkey.

Urolithiasis
|February 22, 2015
PubMed

Insights

Mini-percutaneous nephrolithotomy (PNL) in supine versus prone positions shows similar success and complication rates. The supine approach offers a significantly shorter operative time, making it a promising alternative for kidney stone treatment.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Nephrolithiasis Management

Background:

  • Percutaneous nephrolithotomy (PNL) is a key procedure for kidney stone removal.
  • Patient positioning (supine vs. prone) can influence PNL outcomes.
  • Mini-PNL offers a less invasive approach to stone extraction.

Purpose of the Study:

  • To compare the efficacy and safety of mini-PNL in supine versus prone positions.
  • To evaluate success rates and complication profiles of both positions.
  • To identify potential advantages of one position over the other in mini-PNL.

Main Methods:

  • Retrospective analysis of 180 patients undergoing mini-PNL (May 2009 - Aug 2014).
  • Patients were grouped by position: supine (n=54) or prone (n=126).
  • Success defined as no residual stones >2 mm; complications graded by modified Clavien system.

Main Results:

  • Similar success rates: 85.1% supine vs. 87.3% prone (p=0.701).
  • No significant difference in complication rates between supine and prone groups.
  • Mean operative time was significantly shorter in the supine group (55 min vs. 82 min, p=0.001).

Conclusions:

  • Mini-PNL in the supine position demonstrates comparable success and complication rates to the prone position.
  • The supine position offers a significant advantage with reduced operative time.
  • Supine mini-PNL is a viable and potentially more efficient option for kidney stone treatment.

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