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All patients underwent the procedure in prone-split leg position. A nonpapillary renal puncture was performed. The used access sheaths were 22Fr or 30Fr. Lithotripsy was performed anterogradely with a dual-energy lithotripter with incorporated suction and retrogradely with holmium Yttrium\u2013Aluminum\u2013Garnet laser.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 33 patients were included. The initial stone-free rate (SFR) was 84.8% and the final SFR was 90.9%. The median stone size was 35\u00a0mm and 60% of patients had staghorn calculi. The prevalence of renal abnormalities was 21.3%, including 3 cases of horseshoe kidney, 2 cases of malrotation and 2 cases with complete duplicated systems. The median operative time was 47\u00a0min. The median hospital stay was 3\u00a0days and median hemoglobin loss was 1.2 gr\/dL. Overall, the complication rate was 9.1%, all being Grade II complications (<jats:italic>n<\/jats:italic>\u2009=\u20092 fever and <jats:italic>n<\/jats:italic>\u2009=\u20091 transient bleeding).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Nonpapillary prone ECIRS is an effective and safe procedure. Standardization of the procedure is critical to achieve good outcomes. Patients who benefit the most are probably the ones where additional punctures can be avoided using this technique, namely patients with renal abnormalities, incrusted ureteral stents and staghorn stones.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00345-022-04178-x","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T10:02:39Z","timestamp":1666000959000},"page":"3067-3074","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Nonpapillary prone endoscopic combined intrarenal surgery: effectiveness, safety and tips, and tricks"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6854-4501","authenticated-orcid":false,"given":"Panagiotis","family":"Kallidonis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arman","family":"Tsaturyan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Faria-Costa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Begona","family":"Ballesta Martinez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelis","family":"Peteinaris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantinos","family":"Adamou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Pagonis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasios","family":"Natsos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theofanis","family":"Vrettos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelos","family":"Liatsikos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,10,17]]},"reference":[{"issue":"6","key":"4178_CR1","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1016\/j.eururo.2008.07.073","volume":"54","author":"CM Scoffone","year":"2008","unstructured":"Scoffone CM, Cracco CM, Cossu M, Grande S, Poggio M, Scarpa RM (2008) Endoscopic combined intrarenal surgery in Galdakao-modified supine Valdivia position: a new standard for percutaneous nephrolithotomy? 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