RIRS surgery, also known as Retrograde Intrarenal Surgery, has become an innovative solution in the world of urology. This minimally invasive procedure allows for the treatment of kidney stones and certain other intrarenal issues without the need for incisions. As a highly advanced surgical option, RIRS is performed using a flexible ureteroscope to access the kidneys and treat stones or tumors with precision.

Purpose of RIRS Surgery

The primary purpose of RIRS surgery is the removal of kidney stones or treatment of small kidney tumors. RIRS is specifically recommended in situations where other surgical approaches like Extracorporeal Shock Wave Lithotripsy (ESWL) or Percutaneous Nephrolithotomy (PCNL) may not be effective or feasible.

• Complex Stone Formation: In patients with complex or inaccessible kidney stones, such as those situated in difficult areas of the kidney or stones that have not responded to other treatments, RIRS offers a precise way to address the issue.
• Medical Conditions: Patients who suffer from bleeding disorders, are obese, or have poor kidney function are also suitable candidates for this procedure. RIRS is preferred in these cases due to the low-risk factor compared to open or percutaneous surgeries.
• Failed Previous Procedures: If a patient has undergone other kidney stone treatments, such as laser lithotripsy or ESWL, and these treatments have failed, RIRS may be recommended as a follow-up option.

How RIRS Surgery is Performed

RIRS surgery is performed using a flexible ureteroscope, a specialized instrument that is inserted through the urethra, bladder, and ureter to access the kidney. No incision is made, which significantly reduces recovery time and post-operative complications.

1. Anesthesia: The procedure is generally performed under general anesthesia to ensure the patient is completely comfortable throughout.
2. Insertion of Ureteroscope: The surgeon inserts the flexible ureteroscope through the natural urinary passage (urethra) and advances it up through the bladder and ureter into the kidney.
3. Laser Lithotripsy: Once the ureteroscope reaches the kidney stone, a laser fiber is inserted through the scope to fragment the stones into smaller pieces that can be easily removed or passed naturally through urination.
4. Stone Extraction: After the stone has been fragmented, the smaller pieces are extracted with the help of basket catheters, or they are left to pass out of the body naturally.
5. Stent Placement: In some cases, a ureteral stent is placed to ensure smooth urine flow from the kidney to the bladder post-surgery. The stent helps the healing process and prevents any blockage from residual fragments or swelling.

The surgery generally lasts about 1 to 2 hours, depending on the size and location of the stones or the complexity of the issue being treated. Since RIRS is a minimally invasive procedure, patients can typically go home the same day or after a short hospital stay.

Advantages of RIRS Surgery

RIRS offers numerous advantages over traditional surgical techniques for treating kidney stones and other intrarenal conditions. Some of the most notable benefits include:

1. Minimally Invasive Nature

RIRS is a scarless procedure because it does not require any incisions. The use of a flexible ureteroscope allows the surgeon to access the kidney through the natural urinary tract, eliminating the need for cuts or stitches. This makes the procedure less traumatic for the patient, leading to a faster recovery.

2. Reduced Risk of Complications

Compared to traditional surgeries, RIRS surgery has a lower risk of complications such as bleeding, infection, and post-operative pain. This is especially important for patients who are at high risk due to other health conditions like diabetes, cardiovascular disease, or bleeding disorders.

3. Short Recovery Time

Patients who undergo RIRS surgery typically experience a much faster recovery time compared to those who have undergone open surgery or PCNL. Most patients can return to normal activities within a few days, with less post-operative discomfort.

4. High Success Rate

The success rate of RIRS surgery for the removal of kidney stones is very high, often exceeding 85-90%. This makes it one of the most effective methods for treating complex or inaccessible stones.