Retrograde Intrarenal Surgery

Overview
This is a minimally invasive treatment for ureteric and renal stones. This form of treatment does not involve making a cut on the patient. A flexible scope is passed through patient’s urinary system through the natural orifice. The entire urinary system is visualised with a high definition camera system attached to the scope. Stones located in any part of the urinary system can be broken by using the holmium laser and extracted using miniature baskets.
Stones upto 3 cm can be removed by this procedure. Can be performed as a day care procedure and patients can resume their routine activity next day. Less risk / practically no chances of bleedimg in contrast to other minimally invasive stone removal procedures Even small tumors in the urinary system can be diagnosed by flexible ureterorenoscopy and treated by holmium laser.
Retrograde intrarenal surgery (RIRS) is a minimally invasive treatment for doing surgery within the kidney using a flexible ureteroscope. In RIRS the scope is placed through the urethra (the urinary opening) into the bladder and then through the ureter into the urine-collecting part of the kidney. The scope thus is moved retrograde (up the urinary tract system) to within the kidney (intrarenal). RIRS may be done to remove a stone. The stone is seen through the scope and can then be fragmented by a laser fibre or removed by small forceps or baskets.
The procedure is usually done under general anesthesia, as a day surgery procedure or with an overnight stay
BENEFITS:
- Stones located in any part of the urinary system can be broken by using the laser energy and extracted using miniature baskets.
- Stones upto 3 cm can be removed by this procedure.
- Can be performed as a day care procedure and patients can resume their routine activity next day.
- Less risk / practically no chances of bleeding in contrast to other minimally invasive stone removal procedures
- Even small tumors in the urinary system can be diagnosed by flexible ureterorenoscopy and treated by holmium laser.
Risk
These include :
- Failure to pass the ureteroscope up to the kidney because of tightness of the ureter. In this situation, the urologist will insert a stent. The ureter will relax and the inner diameter will enlarge in response to the stent. RIRS can then be performed a week or two later.
- Failure to fragment the stone – This can happen when the stone is the lower pole of the kidney and the angle is too acute for the ureteroscope to negotiate and visualise the stone for fragmentation.
- Blood in the urine
- Urinary tract infection
- Injury to the ureter resulting delayed scarring and narrowing (ureteral stricture)