Retrograde Intrarenal Surgery (RIRS) in Delhi, India

Retrograde Intrarenal Surgery (RIRS) is a minimally invasive procedure using a flexible ureteroscope to treat kidney stones effectively. It offers several benefits, including no incisions, quicker recovery, and fewer complications than traditional methods.

Who Needs Retrograde Intrarenal Surgery (RIRS)?

• Stone Size: Effective for kidney stones between 10 mm and 14 mm.
• Failed Alternatives: Suitable for patients where treatments like ESWL or ureteroscopy didn’t succeed.
• Precautions: Patients over 65 or with health conditions should consult a urologist before opting for RIRS.

How Retrograde Intrarenal Surgery (RIRS) Works

Before RIRS Surgery

• Patient Evaluation: Doctors assess medical history, overall health, and kidney stone details like size, location, and type for personalised treatment.

• Imaging: Advanced imaging tools such as CT scans or ultrasounds accurately locate stones and guide the surgical plan.

During RIRS Surgery

• Anaesthesia: Spinal or general anaesthesia ensures patient comfort and safety throughout the procedure.

• Ureteroscope Insertion: A flexible ureteroscope is inserted through the urinary tract to access the kidney and locate the stones.

• Stone Identification: A high-resolution camera on the ureteroscope helps locate stones in complex or hard-to-reach areas.

• Laser Fragmentation: A holmium laser breaks kidney stones into smaller pieces, making them easier to remove or pass naturally.

• Stone Removal: Stone fragments are extracted using specialised tools or allowed to pass naturally, depending on their size.

After RIRS Surgery

• Stent Placement: A temporary stent may be placed in the ureter to ensure proper drainage and aid recovery.

• Pain Management: Prescribed medications help manage discomfort and ensure a smoother post-operative experience for patients.

• Follow-up Imaging: Post-procedure imaging confirms stone clearance and checks kidney health to avoid complications.

Risks Associated with Retrograde Intrarenal Surgery (RIRS)

• Haematuria: Blood in urine is common but usually resolves within a few days.
• Pain: Mild discomfort post-procedure can be managed with prescribed painkillers.
• Fever: Low-grade fever is rare but manageable with antibiotics.
• Sepsis: A rare complication requiring immediate medical attention to prevent serious infections.
• Relook Procedure: Some cases may require additional sessions for complete stone clearance.

Possible Complications After RIRS Surgery

• Ureteral Injury: The ureter may sustain minor damage during the procedure but usually heals without long-term issues.
• Infection: Post-operative infections are treated effectively with antibiotics prescribed by your healthcare provider.
• Stent-Related Discomfort: Temporary irritation or pain from the stent that resolves upon removal.

Benefits of Retrograde Intrarenal Surgery (RIRS)

• Day Care Procedure: Patients are usually discharged on the same day, reducing hospital stay duration.
• Quick Recovery: A minimally invasive approach ensures faster recovery compared to traditional surgeries.
• Lower Bleeding Risk: Ideal for patients with bleeding disorders or on blood-thinning medications.
• Precision: A flexible ureteroscope enables access to difficult-to-reach kidney areas, improving treatment outcomes.

Recovery After RIRS Surgery

• Rest: Avoid strenuous activities for at least a week to allow complete healing.
• Hydration: Drink plenty of fluids to help flush out residual stone fragments naturally.
• Pain Management: Follow prescribed medication regimens to minimise post-operative discomfort.
• Diet: Limit foods high in oxalates and sodium to reduce the risk of future kidney stones.
• Follow-up Care: Regular check-ups and imaging ensure complete recovery and prevent recurrence.

Outlook

The long-term outlook for patients undergoing RIRS is excellent. Most patients achieve complete stone removal with minimal discomfort and resume normal activities within a short period. Adopting preventive measures, such as dietary changes and increased water intake, can help reduce the risk of recurrence.

Frequently Asked Questions

1. Is RIRS a major surgery?

No, RIRS is a minimally invasive procedure that avoids external incisions, making it less complex and less invasive.

2. How many days of bed rest after RIRS surgery?

Patients typically need one to two days of rest before resuming light activities, depending on recovery.

3. How painful is RIRS?

RIRS involves minimal pain, which can be managed effectively with anaesthesia during the procedure and medications post-surgery.

4. How long does RIRS take?

The procedure typically lasts between 1-2 hours, depending on the size and location of the kidney stones.

5. Who performs RIRS surgery?

A urologist specialising in urinary tract and kidney treatments performs RIRS using advanced techniques and equipment.