RIRS:

Retrograde intrarenal surgery (RIRS) is a newer and less invasive procedure for removal of stone from kidney by using a fiber optic endoscope. This method allows the surgeon to perform surgery inside the kidney without making an incision. RIRS procedure is very effective for difficult-to-treat cases such as tumours, patients with bleeding disorders and stones in children.

Indication for RIRS procedure include the presence of larger stones, which cannot be removed by Lithotripsy, obesity, presence of strictures or tumors and in case of bleeding disorders.

RIRS procedure is usually done under general or spinal anesthesia. The surgeon will place a ureteric access sheath on a guidewire under continuous fluoroscopy. Now, a flexible ureteroscope is placed through the urethra into the bladder and through the ureter into the kidney.

After that the stone can then be crushed by an ultrasound probe or evaporated by a laser probe. In case of smaller stones, they can be grabbed by the instruments called nitinol baskets. A double J stent is placed at the end of the RIRS procedure for smooth drainage from the kidney and avoid blocking in the ureter.

There are rare complications associated with RIRS procedure in comparison of PCNL.