Experience of Supine PCNL in a Northern Sri Lankan Cohort: Outcomes from Jaffna Teaching Hospital

Introduction: Percutaneous nephrolithotomy (PCNL) is the standard treatment for large and complex renal stones. Supine PCNL has gained attention due to potential advantages over the prone approach, including reduced operative time, easier anaesthetic management, and the feasibility of combined endoscopic procedures. This study evaluates the outcomes of supine PCNL at Jaffna Teaching Hospital, a tertiary care centre in Northern Sri Lanka.
Methods: A retrospective descriptive study was conducted on 191 patients undergoing supine PCNL between 2022 and 2025. Preoperative evaluation was done including CT imaging and laboratory assessment. Procedures were performed using standard 24-26 Fr tracts in the modified Galdakao-Valdivia position. Stone clearance, intraoperative and postoperative complications, and hospital stay were analyzed.
Results: We performed 191 PCNLs in supine position with the mean patient age of 45.3 years (range 2 to 85 years), with males constituting the majority at 61.3%. The procedures were equally distributed between the left and right kidneys (50% each). The mean duration of the procedures was 78.8 minutes. The mean stone clearance rate was
76.9 %. Single-tract PCNL was performed in 90.4% of cases, and complications were minimal.
Conclusion: Supine PCNL is a safe and effective approach in our Northern Sri Lankan cohort, yielding satisfactory stone clearance with low complication rates.