Obese Patient for PCNL in Prone Position

Percutaneous nephrolithotomy (PCNL) has been successfully and safely used to treat patients with renal stones for more than a quarter of a century. Still, the use of PCNL in certain patient groups, such as obese patients is always challenging. Administration of safe anaesthesia to these high risk patients requires knowledge of associated comorbid conditions, availability of adequate personnel and modalities for positioning, physiology of prone position, potential postoperative complications and therapeutic modalities. We present the case of an obese patient posted for PCNL conducted under general endotracheal anaesthesia, where we used a metallic frame to accommodate the abdominal weight and discuss the challenges in conducting such a case.