RETROGRADE INTRARENAL SURGERY (RIRS) & LASER LITHOTRIPSY FOR KIDNEY STONES
Who Performs This Surgery?
While surgery can improve symptoms dramatically, TURP can have significant unwanted side effects. You should discuss the pros and cons of both medical management and surgery with your doctor before you make a decision.
- Failed attempts at treatment
- Kidney stones too large for treatment by lithotripsy
- Strictures in the kidney
- Tumors in the kidney
- Kidney stones among children
- Bleeding disorders in the kidneys
- Grossly obese patients
Retrograde Intrarenal Surgery (RIRS): This procedure refers to surgery done inside the kidney with a viewing tube, better known as a fiber optic endoscope. Due to recent technological strides in this field, it has become possible to implement Retrograde Intrarenal Surgery (RIRS) to manage kidney stones.
How The Surgery Is Performed
Before the procedure
Surgery
This is a novel technique to remove kidney stones. The ureteroscope can easily remove kidney stones of a maximum of 1.5cm in size. When passed into the kidney through the bladder, the kidney stones are identified and blasted using a laser. For the ureteroscope to enter the kidneys easily, the ureteroscopy is first dilated by placing a Dj stent in the affected kidney two weeks before the surgery is performed. This leads to quicker recovery of the patient and he or she can resume their daily lives from the third day after surgery.
Post-Surgery
After completing RIRS, the patient will be taken to the recovery room where he will receive intensive care. A urine catheter will be fitted into the urethra for a day for minimizing the pain and difficulty while urinating.
The patient will be advised bed rest 24 hours after receiving spinal anaesthesia and to drink plenty of water so that 2.5 liters of urine output per day can be maintained and infections kept at bay. However, if the patient is well enough, he or she need not rest but can be discharged the day after surgery. The doctor can ask to see the patient five days after being discharged from hospital.
Advantages of this procedure
Retrograde Intrarenal Surgery for stone extraction is quicker than traditional open surgery. Besides, patients do not experience pain after surgery and overall, they recover much faster. There is also minimal bleeding and the renal tissue is free of damage. This procedure also produces better clearance of kidney stones.
RIRS is being seen as a safe retrograde endoscopic procedure to treat renal calculi. However, if patients have stones larger than 20mm diameter or several small calculi, especially along with pre-existing tubes or after experiencing urinary tract infections, they belong to a small section of patients at high risk for complications and will not get complete satisfaction from RIRS.