الفهرس 
Anatomy of the kidneyOnly 14 pages are availabe for public view
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Abstract
PCNL nowadays is considered the gold standard which has the upper hand for management of kidney stones more than 2cm.
Complications associated with supracostal approach is specific and can be managed when detected intraoperatively and early post-operatively
Chest complications including hydrothorax, pneumothorax and hemothorax are the most common complications associated with supracostal approach but, they can be avoided by doing the intercostal puncture during expiration in the middle of the 11th intercostal space just lateral to the midscapular line.
Obese and morbidly obese patients fit for anesthesia can do the supracostal PCNL safely.
Excessive bleeding is not frequent in the supracostal approach when the puncture is made through the calyceal fornix.
The supracostal access is very helpful in clearing the upper calyceal stones that could not be removed by the lower calyceal access
Supracostal approach in managing kidney stones as a single access technique or as a part of multiple access technique is considered safe especially in well experienced hands. Meanwhile it is necessary in certain circumstances where the subcostal approach alone is not very helpful in rendering the patient stone free.