Navigating Complexity: The Success of RIRS in a Morbidly Obese Patient with 6 O’clock Working Channel

Obesity, defined as a BMI≥30 kg/m2, affects 21.8% of the population in Indonesia, reported by the national health survey. Obesity and morbid obesity are often associated with various health problems, including urinary tract stones. Various procedures, including URS, SWL, PCNL, and RIRS, are used to treat this condition. However, managing morbidly obese patients with nephrolithiasis remains uncommon in Indonesia, necessitating awareness among urologists to optimize treatment outcomes. RIRS is known for its lower morbidity, fewer complications, and cost-effectiveness compared to other surgical procedures. Here, we present a successful case of RIRS in a morbidly obese 43-year-old man with multiple nephrolithiasis with a size of 12.6 x 11.4 mm at middle posterior calix. RIRS is considered a safe and feasible treatment for managing nephrolithiasis in morbidly obese patients.