Case information: Male, 61 years old. He had intermittent right low back pain for more than 10 years, aggravated for 2 months with fever. There was no elevation in the renal area, no percussion pain in the right kidney area, and no pressure pain in the ureteral region. The right renal pelvis was dilated and a stone of 2.9×2.2cm in the renal pelvis . Methods: Microstomy percutaneous ureteroscopic lithotripsy. General anesthesia (low efficiency of ballistic lithotripter only, considering the reason of long operation time), healthy side lying, lumbar bridge padded, head and lower limbs properly lowered, healthy side hip and knee flexed, affected side lower limbs straightened. The head, axilla, lumbar bridge and knee joint are padded. PCNL is used more rarely in the lateral position and is generally used for people with kyphosis, morbid obesity, and pulmonary dysfunction. The advantages are: avoiding the limitation of spinal thoracic deformity on the position; reducing the impact of respiratory and circulatory system caused by prolonged weight compression; the lowest position of renal pelvis, the fragmentation is not easy to enter other renal calyces, and the treatment of renal calyx stones is easy to fall into the renal pelvis; the elevated lumbar bridge can widen the spacing between the rib arch and iliac crest, which can make the puncture point on the rib move down to the subcostal in the prone position; facilitating the change of open surgery. Disadvantages: large angle between the channel and the horizontal, inconvenient to operate; lithotripsy is not easy to flush out (it is more problematic to deal with medium-sized stones entering the pelvic ureter); the patient suffers from postural discomfort.