Urinary calculosis treated surgically in the modified valdivia position: A report of four cases

Since January 2010, four patients with urinary calculosis have undergone surgical treatment in the modified Valdivia position in our hospital. They comprised two males and two females, with ages ranging from 26 - 75 years old. Three of the patients were difficult to operate on in the abdominal position and one of them needed to be treated with both antegrade and retrograde lithotripsy. The former three cases were treated by percutaneous nephrolithotomy (PNL) in the modified Valdivia position. In the latter case, we discovered an obstruction at the site of the left ureteral stone. The stone was situated at the L4/5 high. We were unable to get past the obstruction using retrograde surgery only. We therefore performed surgery in the retrograde and antegrade fashion simultaneously, and the site of obstruction was widened by means of a Holmium LASER. If the patient is placed in the modified Valdivia position, it is possible to operate on patients who are obese or bedridden much more safely than if they were placed in the abdominal position. Furthermore, it is possible to carry out transurethral lithotripsy (TUL) at the same time, if necessary. We conclude that carrying out surgery in the modified Valdivia position is very beneficial.