Patient positioning during percutaneous nephrolithotomy (PCNL): is there an optimal position?

Percutaneous nephrolithotomy (PNL) is the gold standard procedure for large stones and complex kidney anatomy, but in the same time its morbidity remains the highest among stone treatment procedures. In pursuit of minimizing complication rates surgeons have developed different variations of the classic prone position but in the same time and with the same goal, supine position was introduced. In our study, we review the literature about all available evidence on different variations in positioning during PCNL, in an effort to clarify if there is a position that makes the difference in terms of minimizing the morbidity of this procedure.