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a 56 year old female was planned for left side PCNL due to 5 renal stone in different lower and mid segment calyxes of her left kidney,     
a 56  year old female was planned for left side PCNL due to 5 renal stone in different lower and mid segment calyxes  of her left kidney, Preop IVU should narrow calyxes and caleseal stone with fine infundibla.
 
as routine operation day KUB was obtained prior to call to operation room which revealed a different stone conformation which changed the surgical planning , patient underwent left side PCNL with double Y configuration quadri- access procedure and was rendered stone free by Dr Aghamir and Salavati.
 
such presentation of spontaneous stone displacement in such narrow infundibula was a surprising phenomenon which mandates a fresh  KUB for every patient undergoing renal stone surgery on call to operation room if possible.

 

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