Now the next is RIRS Treatment for kidney stones. This is the latest advanced technique. In this, we insert a telescope through the penis. RIRS stands for Retrograde Intrarenal Surgery. Retro means to go backward. The urine passes from the kidney through the ureter to the urinary bladder and then out of the body. But we are going backward, from the urethra to the bladder, to the ureter, and then to the kidney, therefore retrograde. And we go all the way to the kidney, therefore intrarenal.
We have a special telescope. It is very flexible and can also be called flexible ureteroscopy. It can go to every part of the kidney. As you can see it can bend to 270-290 degrees in every direction. It can be controlled with the thumb. With this telescope, we go from the urethra to the kidney. Like I said before there is upper, middle, and lower calyx in a kidney. And this can go to all the three calyces. With the help of the thumb and the movement of the wrist, this can reach all the places in the kidney.
There is a video scope and the other is a fiber optic scope. These two look the same but in this, there are processors and fiber optic cables and the other one has a video scope. The vision of the video scope is better compared to the fiber optic scope. Various companies make these gadgets. So we go into the kidney with a fiber optic and with a laser breakdown the stone.
A 2-2.5 cm stone can be broken down by laser with this. After this, we put a stent that helps the stone fragments to pass out of the body within 2-3 weeks.
RIRS is beneficial when the stone is less than 2-2.5 cm. There are no cuts involved so the recovery is fast and the patient can go be discharged in the evening or early morning. The functioning of the kidney is not compromised as there are no cuts made in the kidney. The other advantage is that a solitary kidney can be preserved. If the patient is taking blood thinners then it is not a problem as the surgery requires no blooding or cuts.
So if the stone is smaller than 2-2.5 cm then this is the best option a patient can opt for. RIRS has an advantage over lithotripsy as it can also break down stones located in the lower calyx. If the stones are bigger than 2-2.5 cm then the patient needs more than one sitting.
These are the three disadvantages of RIRS.
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