Technical tips for prone ECIRS

- Prone position similar to conventional PCNL with appropriate Allen stirrups.

- To guarantee the operative space around the urethra, use the adhesive plaster surgical tapes to manage the hips and the labia majora (females) and the scrotum (males)

- Hide the anus

- Drapes for urethral first and the PCN site next.

- Urethral procedures first (insertion of guidewires, ureteral catheters, or access sheaths): (i) shoulder pads for Trendelenburg position, ii) the elevated surgical table because of the angled urethra. (iii) may use the flexible ureterorenoscope directly to the ureteral orifice

- PCN puncture using the bull's eye technique or the triangulation technique

- Perform 18Fr MPCNL