ECIRS: a new proposal for the patient position

Willy Giannubilo1, Maurizio Diambrini1, Behrouz Azizi1, Carlo Scaldazza Vecchioli1, Paola Fulvi1, Vincenzo Ferrara1
  • 1 Ospedale Carlo Urbani, U.O.C. Urologia (Jesi)


Intrarenal Combined Endoscopic Surgery (ECIRS) is a combination between retrograde intra-renal (RIRS) and percutaneous nephrolithotripsy (PCNL) surgery.
It is a very effective technique to treat: complex renal stones and contextual ureteral ones, in case of uretero-pelvic junction obstruction.
Most important things to perform this procedure are: surgical instruments, patient's position, side of kidney puncture/dilation, intracorporeal lithotripsy, nephrostomy/stenting.
Valdivia Uria – Galdakao modified position is milestone to the technique development, according to the undoubted surgical and anesthetic advantages.
The video shows our procedure to perform ECIRS, using a new modified position, which in our experience can allows:
– patient in supine position, avoiding his 30 ° inclination on the operatory table
– respect of anatomical access to the kidney
– more space for the surgeon to perform the procedure
– increased chance to spontaneous leaking gravity of stones fragments