LASER SURGERIES FOR KIDNEY STONES

Retrograde Intra Renal Surgery or RIRS is the latest method of kidney stone laser surgery without any incisions on the body. This is a very safe, efficient and reliable method to remove renal stones. It is an endoscopic surgery and performed through the natural orifice. The doctor uses an endoscope – a thin, flexible tube with a camera at the end of it – to get to the bladder through the urethra. The endoscope moves further to the area of urine storage in the kidney and during the process, it identifies the stones and blasts them with a laser.

Kidney stones up to the size of 5 cm can be treated by this method. If stones are present in both kidneys, they can be treated together at the same time. The stones can be cleared well by this method.

Procedure

• Initial Examination: At your consultation visit, we will check your kidney function and perform a screening ultrasound to see the number of stones and their size. During the comprehensive urology examination, we will measure the density of your stones to ensure the best laser setting to remove them. We will also make a road map of the approach to your kidneys (map of the KUB) and check the overall health of your kidneys.

• Duration: The duration of RIRS Surgery depends on the size of the stone. Large stones take more time, while average to normal-sized stones would take around half an hour for the procedure.

Advantages of RIRS

• Minimally Invasive: RIRS is a minimally invasive surgical technique, requiring no incisions. Instead, a flexible ureteroscope is passed through the natural urinary passages, minimizing trauma to surrounding tissues and reducing recovery time.
• High Success Rates: RIRS has shown high success rates in treating smaller to medium-sized kidney stones, particularly those located in the renal pelvis or calyces. The procedure effectively allows the urologist to visualize and treat stones in the kidney.
• Versatility: RIRS is versatile and can be used to treat various types of kidney stones, including those that may be challenging to reach with other methods. It is suitable for both simple and complex stones.
• Short Recovery Time: Compared to more invasive procedures like percutaneous nephrolithotomy (PNL), RIRS typically involves a shorter recovery time. Patients often experience less pain and can resume normal activities sooner after the procedure.
• Reduced Pain and Discomfort: Since RIRS is a minimally invasive procedure, it generally causes less pain and discomfort than traditional open surgeries. Most patients can manage postoperative pain with mild pain medications.
• Lower Infection Risk: The risk of infection is relatively low with RIRS. Antibiotics may be prescribed before or after the procedure to further reduce the risk of infection.
• Outpatient Procedure: In many cases, RIRS can be performed on an outpatient basis, allowing patients to go home the same day as the procedure. This can contribute to increased convenience and decreased healthcare costs.
• Lower Risk of Scarring: RIRS avoids the need for external incisions, minimizing the risk of visible scarring. This can be particularly important for patients concerned about cosmetic outcomes.
• Applicability for Special Populations: RIRS is suitable for a wide range of patients, including those who may not be candidates for more invasive procedures. It can be used in pregnant women, elderly individuals, and those with specific health conditions.

Is RIRS Safe?

Retrograde Intrarenal Surgery (RIRS) is generally considered a safe and effective procedure for the treatment of kidney stones. However, like any medical intervention, it carries potential risks and complications. The safety of RIRS depends on various factors, including the patient's overall health, the characteristics of the kidney stones, and the skill and experience of the surgical team.

• Effectiveness: RIRS is often effective in treating smaller to medium-sized kidney stones, particularly those located in the renal pelvis or calyces. The procedure allows the urologist to access and remove or fragment stones using a flexible ureteroscope.
• Minimally Invasive: RIRS is a minimally invasive procedure, which means it is associated with fewer complications and a shorter recovery period compared to more invasive surgeries like open surgery or percutaneous nephrolithotomy (PNL).
• Anesthesia Risks: Like any surgical procedure, RIRS involves the use of anesthesia. Anesthesia-related risks will depend on the patient's health status, and the anesthesiologist will assess and manage these risks.
• Infection Risk: While infection is a potential risk with any surgery, RIRS is generally associated with a low risk of infection. Antibiotics may be prescribed before or after the procedure to minimize this risk.
• Bleeding: Some degree of bleeding may occur during or after RIRS. While significant bleeding is uncommon, patients may experience minor bleeding that usually resolves on its own or can be managed by the medical team.
• Ureteral Injury: There is a small risk of injury to the ureter during the insertion of the ureteroscope. Experienced surgeons take precautions to minimize this risk.
• Residual Stone Fragments: In some cases, small fragments of the stone may be left behind after RIRS. These fragments may pass on their own or require additional interventions.

When RIRS is Needed?

• Stone Size and Location: RIRS is often used for the treatment of smaller to medium-sized kidney stones, particularly those located in the renal pelvis or calyces. The procedure is effective for stones that may be challenging to reach with other methods.
• Ineffectiveness of Conservative Measures: When conservative measures such as increased fluid intake, medications, or lifestyle modifications fail to alleviate symptoms or facilitate the passage of kidney stones, RIRS may be considered as an intervention.
• Persistent or Recurrent Stones: If a person has a history of recurrent kidney stones or experiences persistent stones that do not pass spontaneously, RIRS may be recommended to remove or break up the stones.
• Obstruction and Hydronephrosis: Kidney stones causing obstruction of the urinary tract, leading to symptoms such as hydronephrosis (swelling of the kidney), may require intervention. RIRS can help alleviate the obstruction and manage related symptoms.
• Failure of Other Treatment Modalities: If other non-invasive treatments such as shock wave lithotripsy (SWL) or ureteroscopy have been attempted but are not successful or are deemed inappropriate for the specific case, RIRS may be considered.
• Large or Complex Stones: While RIRS is generally suitable for smaller stones, advancements in technology and surgical techniques have expanded its applicability to larger or more complex stones in certain cases.
• Patients Unfit for Other Procedures: Some patients may not be suitable candidates for other surgical procedures like percutaneous nephrolithotomy (PNL) or extracorporeal shock wave lithotripsy (ESWL) due to health concerns or anatomical factors, making RIRS a preferred option.

What Would Disqualify Me from RIRS Surgery?

• Stone Size and Location: RIRS may not be suitable for very large stones or stones located in certain parts of the kidney that are challenging to access.
• Anatomical Abnormalities: If you have certain anatomical abnormalities or variations in the urinary tract, it might affect the feasibility and safety of the procedure.
• Medical Conditions: Certain medical conditions such as bleeding disorders, severe heart or lung disease, or active urinary tract infections might be contraindications for RIRS.
• General Health Status: Overall health, including factors such as poor general health, advanced age, or significant comorbidities, may affect the suitability of RIRS.

Recovery Time

The normal recovery time after RIRS Surgery is one day and patients can continue their routine work after a day’s rest.

Cost

The cost of RIRS Surgery depends on multiple factors but it is definitely affordable to the normal population and is easily accessible.

Advantages

Certain advantages of RIRS Surgery include:

• It is Minimally Invasive (meaning no incisions or cuts are made)
• The procedure is simple
• The patient doesn’t need to stay in the hospital for more than one day
• The recovery period is short
• Fewer complications
• No bleeding
• Both sides can be treated together
• Can be performed for both children and adults alike
• Since the procedure is done after giving anesthesia, the surgery is absolutely painless.

Why Choose Genesis Superspeciality Hospital for RIRS (Retrograde Intra Renal Surgery)?

Genesis Superspeciality Hospital always prioritizes patient safety, comfort, and satisfaction throughout the treatment process. Dr. Raju R possesses a remarkable history of achieving successful results and holds substantial expertise in RIRS (Retrograde Intra Renal Surgery). With exceptional surgical outcomes and competitive pricing, our facility offers prompt surgical scheduling, minimizing patient wait times.