Urinary stones are a common condition of the urinary system, with ureteral and renal stones being referred to as upper urinary tract stones. Although the traditional lithotomy position is widely used in retrograde treatment of upper urinary tract stones, it has limitations such as complex positioning and a higher risk of postoperative nerve injury. Therefore, exploring a more efficient and safer surgical position is of significant clinical importance. This study, through summarization and improvement, proposes the supine split-leg position as a new position for retrograde treatment of upper urinary tract stones, aiming to enhance surgical efficiency and patient comfort, and reduce the incidence of postoperative complications.

Patients diagnosed with upper urinary tract stones and undergoing retrograde intrarenal surgery at the University of Hong Kong-Shenzhen Hospital from July 2024 to November 2024 were included in the study.Inclusion criteria:①Ureteral stones or stones in the middle/upper calyces of the kidney;② Stone diameter ≤ 2 cm.Exclusion criteria:①Pre-existing urological diseases;②Pre-existing history of deep vein thrombosis in the lower limbs;③Severe cardiopulmonary diseases;④ Hematological disorders or coagulation abnormalities;⑤ History of lower limb trauma or restricted abduction;Based on intraoperative positioning, the experimental group was placed in the supine split-leg position(n=38), while the control group adopted the traditional lithotomy position(n=34).The experimental group comprised 21 females and 17 males, with a mean age of 50 ±12 years.The control group included 7 females and 27 males, with a mean age of 49 ±12 years.

There were no significant differences in baseline characteristics such as age, BMI, stone size, stone hardness, stone location, urinalysis, and urine culture between the experimental group and control group (p>0.05). However, the experimental group demonstrated significantly shorter operative time compared to the control group (43±17mins vs 64±20mins, p<0.05). Both groups achieved comparable clinical outcomes with stone-free rates of 100% and 94.1% respectively, and showed no significant difference in postoperative hospital stay (2 days for both groups). Notably, neither group experienced any position-related complications during the procedures.

The supine split-leg position demonstrates favorable efficacy and safety in the retrograde treatment of upper urinary tract stones, offering a more efficient and convenient surgical position option for clinical practice.