Inferior distraction of the kidney to aid upper pole and supracostal punctures during supine percutaneous renal access.

and a subcostal approach is used to reduce the risk of intrathoracic complications. Better knowledge of pleural and diaphragmatic anatomy and further development in surgical techniques have reduced the risk of intrathoracic complications, but published series report rates of intrathoracic complications varying between 3.1% and 12.5% in those undergoing supracostal percutaneous access. These series further report that the rate of intrathoracic complications is sigth rib compared to a supra-12 Puncture. There