Dr. Nitin Negi

RIRS: Retrograde Intrarenal Surgery

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.
Using Retrograde Intrarenal Surgery Technology, this procedure can also be performed to remove kidney stones, which can be seen through the endoscope and later crushed or blasted using an ultrasound probe or evaporated using a laser probe or could be manually removed using a pair of small forceps.

Who performs this surgery?

A urologist with specialized expertise in RIRS is best suited to performing RIRS. Retrograde Intrarenal Surgery procedure is done under local, spinal or general anaesthesia using flexible ureteroscopy and laser. This surgery is performed inside the kidney without making any cuts, something made possible by sending the instrument for this procedure through the urethra and into the kidney.

This outpatient procedure is best done for patients suffering with kidney stones, narrowing of the kidney outlet within and outside of it and kidney tumours. This minimally invasive urology procedure is generally used for cases that are otherwise difficult to treat, such as :

  • Failed attempts at treatment
  • Kidney stones too large for treatment by lithotripsy
  • Strictures in the kidney
  • Tumours in the kidney
  • Kidney stones among children
  • Bleeding disorders in the kidneys
  • Grossly obese patients

Surgery

Retrograde Intrarenal Surgery techniques are absolutely remarkable. It is performed by a urologist by passing the endoscope through the urethra into the bladder and through the urethra into that part of the kidney where urine is collected. The scope thus is removed at the upward end of the urinary tract system and within the kidney or intra-renal.

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 laser. For the urteroscope 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.