Percutaneous Nephrolithotomy in the Prone and Prone-Flexed Positions: Anatomic Considerations

Ray, A. Andrew; Chung, Dae-Gyun; Honey, R. John D'a.

doi:10.1089/end.2009.0294

Cited by 69 publications

(39 citation statements)

References 31 publications

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“…Although prone is still the most widely practised position [1], the last decade has seen the emergence of a variety of positions for carrying out PCNL, including prone flexed [2], split-leg [3], lateral [4], supine [5,6] and the modified supine positions [7,8]. …”

Section: Introductionmentioning

confidence: 99%

The Barts ‘Flank-Free’ Modified Supine Position for Percutaneous Nephrolithotomy

Bach

Goyal²,

Kumar³

et al. 2012

Urol Int

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Background: The last decade has seen the emergence of a variety of supine positions for carrying out percutaneous nephrolithotomy (PCNL). These positions all differ with regard to ease of puncture under image guidance, operative field availability, ability to make and dilate multiple tracts and ease of combining retrograde intrarenal surgery (RIRS). As all of these positions have their limitations regarding the important parameters mentioned above, there is a need for a supine position which addresses some of the difficulties. Methods: We describe and illustrate our flank-free modified supine position, which we believe addresses a number of the issues. Results: Our position allows easy percutaneous access under fluoroscopy (torso only tilted to around 15°), space for placing (flank free of support) and dilating multiple tracts (kidney lies in a fairly neutral position and hence less mobile), a fairly horizontal tract allowing low intrarenal pressures and easy washout of fragments as well as allowing RIRS in a position of relative familiarity. The lesser torso rotation compared with the Valdivia, Galdakao modified and the Barts modified Valdivia positions also means it is more comfortable for patients. Conclusions: Our results are encouraging and easily comparable with published series on prone position, Valdivia, complete supine and the Barts modified Valdivia positions. We would like to highlight the Barts ‘flank-free’ modified supine position as one of the standard positions for carrying out supine PCNL.

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Section: Introductionmentioning

confidence: 99%

The Barts ‘Flank-Free’ Modified Supine Position for Percutaneous Nephrolithotomy

Bach

Goyal²,

Kumar³

et al. 2012

Urol Int

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“…The appearance of the Foley catheter balloon inflated with contrast was similar to a round vesical calculus and that caused apprehension in the patient’s mind that was relieved on doing the check X-ray after removal of the Foley catheter. Access into the pelvicalyceal system (PCS) for PCNL is usually done via fluoroscopy-guided puncture with the patient in prone position 1. A ureteric catheter is placed before this so that the contrast solution can be instilled into the PCS for identifying the calyceal anatomy and also it can be used to flush small fragments of calculus during PCNL.…”

Section: Descriptionmentioning

confidence: 99%

Inadvertent inflation of Foley catheter balloon with contrast: an error that caused unnecessary apprehensions

et al. 2018

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“…The PCNL was performed in the prone-flexed position used by our group, which has been previously described. 11 A supra-12 th rib access was used to enter a posterior upper pole calyx. A ureteral stent was placed at the end of the procedure with no nephrostomy tube drainage postoperatively, as is the routine procedure in uncomplicated cases at our institution.…”

Section: Casementioning

confidence: 99%

Flank bulge following supracostal percutaneous nephrolithotomy: a report of 2 cases.

Lantz

2013

CUAJ

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case report E547Cite as: Can Urol Assoc J 2013;7(7-8):e547-9. http://dx.doi.org/10.5489/cuaj.176Published online August 19, 2013. AbstractDamage to intercostal nerves during surgical procedures has been associated with a postoperative flank bulge, due to denervation of the anterolateral abdominal wall musculature. This complication has not been reported following percutaneous nephrolithotomy (PCNL). We are aware of 3 cases, but have details on 2 cases of postoperative flank bulge following supracostal PCNL which are reported here. We also suggest how this complication could potentially be minimized.

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Percutaneous Nephrolithotomy in the Prone and Prone-Flexed Positions: Anatomic Considerations

Abstract: Prone-flexed positioning is a simple modification that provides improved access to the upper pole and more mobility for lower pole percutaneous nephrolithotomy. This position is well tolerated and has several advantages over other patient positions, including the supine position.

Cited by 69 publications

References 31 publications

The Barts ‘Flank-Free’ Modified Supine Position for Percutaneous Nephrolithotomy

The Barts ‘Flank-Free’ Modified Supine Position for Percutaneous Nephrolithotomy

Inadvertent inflation of Foley catheter balloon with contrast: an error that caused unnecessary apprehensions

Flank bulge following supracostal percutaneous nephrolithotomy: a report of 2 cases.

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