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Endoscopic Kidney Stone Surgery-RIRS

In RIRS or Retrograde Intrarenal Surgery, a flexible thin endoscope is passed into the kidney through the natural opening and then the stones are broken up under direct vision using a laser. The stone clearance rate is very high, complications are minimal, and the patient is discharged within 24 hours. It is also very expensive and not suitable for all types of stones.

Ideal for stones in the upper ureter or kidney. A flexible binocular is passed through the ureter in the kidney and the stones are broken up using laser. Fragmented stones will come out gradually over a few days or weeks. Larger items can be picked up using grippers and zero-end baskets.

RIRS is a good alternative to PCNL, which is more invasive and has a higher probability of significant bleeding. However, for RIRS such as large stones usually >1.5 cm is not suitable or may require multiple sessions.

Sometimes the stones can be at a difficult location to reach. Sometimes the narrow ureter does not allow the device to pass through the ureter. In such a case, a DJ stent should be placed in the ureter 10-15 days before the RIRS. Thanks to the stent, the urinary canal expands and surgery can be performed. 

The RIRS usually takes 30-60 minutes to perform. Preoperative examinations such as USG, IVP, and urine culture are mandatory. Detailed pre-anesthesia controls are made. Patients are hospitalized on the day of surgery. Usually discharged within 24 hours. Possible complications such as mild to moderate bleeding and fever are occasionally encountered and easily treated.

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