Prone Split-Leg Position for Simultaneous Retrograde Ureteroscopic and Percutaneous Nephroscopic Procedures

Occasionally, during the course of endourologic procedures, there is need for percutaneous nephroscopy, cystoscopy, and retrograde ureterscopy in the same patient. This may involve repositioning the patient from the lithotomy to the prone position during the procedure. Simultaneous access for cystoscopic and percutaneous nephroscopic and retrograde ureteroscopic procedures can be obtained by placing the patient in the prone position with the legs abducted using split-leg adapters for a standard urologie endoscopie table. Access is thus afforded to the urethra for cystoscopic and retrograde ureteroscopic procedures, as well as to a percutaneous nephrostomy tract. Endourologic procedures can be performed under either general anesthesia or with intravenous sedation. We have used this position in 10 patients in whom simultaneous nephroscopic and ureteroscopic access was necessary, and it has proved to be valuable. Operator comfort is maintained while providing excellent percutaneous nephroscopic, cystoscopic, and retrograde ureteroscopic access for therapeutic and diagnostic procedures.