In this procedure, a flexible telescope is used to access each part of the kidney from within. With the help of Holmium laser, the stones are broken into fine particles and removed.
This procedure is preferably done under general anaesthesia.
Preoperative Intravenous Urogram(IVU) is done to check the location of the stone and confirm the functioning of the kidney. Other blood tests and work up to assess fitness for operation are done preoperatively.
Indications:
- Renal stones 10-20 mm in size
- Tumors
- diagnostic to check for cause of blood in urine
This procedure is of great advantage to patients with bleeding diathesis, morbid obesity, malrotated/malpositioned kidney, horse shoe kidney, and calculus (<1.5 cm) in unfavorable lower calyx.
Advantages:
- Decreased morbidity/pain compared to PCNL/Mini perc
- Decreased risk of bleeding
- Earlier recovery
Complications:
- Infection/sepsis
- Sub-capsular Haematoma
- Residual insignificant fragments
- inability to pass scope into kidney due to tight lower ureter. In such cases, DJ stenting is done so that ureter gets dilated and RIRS is done after 7-10 days.