Supine Valdivia and modified lithotomy position for simultaneous anterograde and retrograde endourological access

Ureteroscopy assisted retrograde nephrostomy (UARN) in patient with lower pole renal stone

“…US-guided puncture to the renal collecting system with subsequent placement of a drainage tube under fluoroscopic guidance is the standard modality for performing PCNL. However, applying USguided nephrostomy is difficult without dilating the renal collecting system, even if an occlusion balloon catheter is used to create hydronephrosis [9]. The limitation of this procedure is that it is only effective for relatively small stones after initial fragmentation using a Ho:YAG laser.…”

Surgical outcomes of Modified supine vs Prone position in Percutaneous Nephrolithotomy

“…The first described supine position was that of Valdivia in 1998, with a 3-L saline bag below the flank. This position was further modified in 2006, with the Galdakao modified Valdivia position consisting of some rotation to the supine positioning of the contralateral leg in flexion and the ipsilateral leg in extension 8 . The Bart's modified Valdivia position, resulting in a larger surface area for easy access by manipulating the Nephroscope was first described in 2008 9 .…”

Residual fragments after percutaneous nephrolithotomy

“…The technique and first major series of supine PCNL (sPCNL) was described and reported by Valdivia-Uria and then the technique was improved by Ibarluzea (37,38). As a combined procedure with PCNL, Scaffone et al (39) treated 127 patients with mean 23.8 mm urinary stones in the Galdakaomodified supine Valdivia position, which allows simultaneous application of PCNL and retrograde ureteroscopy (ECIRS, Endoscopic Combined Intra-Renal Surgery) with a stone free rate of 81.95% after the first intervention.…”