Safety and Efficacy of Supine PCNL in the Management of Partial and Complete Staghorn Renal Calculi

Supine PCNL has emerged as a promising alternative to prone PCNL for managing large and complex renal stones, including staghorn calculi. This prospective study included 52 patients with partial or complete staghorn stones undergoing supine PCNL at the Department of Urology in a Tertiary Teaching Hospital in Hyderabad, Telangana, India. The primary endpoints included stone-free rate (SFR), operative duration, hemoglobin drop, hospital stay, and complication rates. Supine PCNL was performed in a flank-free modified position. The results showed a mean operative time of 77.8 minutes and a 90.4% stone clearance rate. The average hemoglobin drop was 0.83 g/dL, with most patients experiencing no or mild complications. The procedure demonstrated safety, efficacy, and ergonomic benefits. Comparable to earlier studies, our outcomes suggest that supine PCNL is a viable approach for staghorn stones.