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Under general anesthesia, the patients were placed in the Galdakao-modified supine Valdivia (GMSV) position [Figure 1]a, thus allowing both antegrade and retrograde access.
For all ECIRS procedures performed, insertion of the guidewire through the ureteral orifice, insertion of the access sheath, manipulation of the flexible ureteroscope, and fragmentation of the stones were easily achieved within the patient because of passive dilatation with prior stenting and the GMSV position.