PCNL is usually performed in the prone position, as it is believed that this approach provides a large working space with a lower incidence of organic and vascular injury. The prone position has potential disadvantages, including longer operative time, patient discomfort, a compromised circulation and interference with ventilation, especially in obese patients.Various modifications of patient positioning for PCNL have been tried, as urologists have begun to understand more abiut the surface anatomy of the kidney and related viscera. These include reverse lithotomy, supine and lateral decubitus positions.Supine PCNL has potential advantages of:less patient handling,a quicker operation,better drainage through the Amplatz sheath, andthe ability to perform simultaneous PCNL & ureteroscopic procedures.I will present my technique of puncture for supine PCNL and demonstrate live supine PCNL surgery. I very much look forward to seeing you in Dartford, where we will provide you with the highest quality of supine PCNL surgery in a relaxed and friendly atmosphere.