RIRS (retrograde intrarenal surgery): Retrograde intrarenal surgery (RIRS) is a procedure for doing surgery within the kidney using a viewing tube called a fiberoptic endoscope.

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 manipulated or crushed by an ultrasound probe or evaporated by a laser probe or grabbed by small forceps, etc.

RIRS is performed by a specialist, an urologist (endourologist) with special expertise in RIRS. The procedure is usually done under general or spinal anesthesia.

The advantages of RIRS over open surgery include a quicker solution of the problem, the elimination of prolonged pain after surgery, and much faster recovery.

Before procedure : Pre operative checkups to ascertain the position of the stone the general health condition of the patient and his response to anaesthesia will be conducted one or two weeks before the admission for retrograde intrarenal surgery will be done on the previous day of the surgery. Pre operative Dj stenting will be done 2 weeks prior to RIRS surgery. This procedure is generally carried out under general anaesthesia. On the day of the surgery the patient expected to fast for 4-6 hours.

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.

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.

you can also consult for Laser Lithotripsy for kidney stones with your doctor and depending on his suggestion you may do whichever surgery is better for you.