Millions of people worldwide suffer from painful kidney stones, a common urological condition. When a stone becomes too large to pass naturally or causes intense pain, seeking medical assistance is essential. One of the most advanced and least invasive treatment options out there is called Laser RIRS (Retrograde Intra-renal Surgery). With this procedure, it is possible to use lasers to break up the stones, providing the patient with a very effective solution that requires almost less recovery time. In this blog, we'll look into the details of Laser RIRS, what it is, how it works, its benefits, if you will have to go through it, and what is the procedure for that.
What is Laser RIRS?
Laser RIRS is a new treatment that can be used to remove kidney stones that are located in the upper urinary tract or kidney. It is an endoscopic method, meaning it doesn't require any incisions. The urologist inserts a flexible ureteroscope through the urethra, up the urinary tract, and into the kidney. After the scope is in position, a laser is employed to break down the stone into smaller pieces, which can be then passed naturally or removed with specialized tools.
Laser RIRS is the preferable approach for kidney stones that are difficult to treat with non-invasive methods such as shock wave therapy or those that are large enough to require surgery. It is also an excellent alternative for patients whose past treatments were ineffective or who have difficult-to-reach stones.
How Does Laser RIRS Work?
The Laser RIRS technique consists of the following steps.
- Preparation: You will undergo a CT scan or X-ray in order to accurately position the stone. You will be given general anesthesia or spinal anesthesia.
- Insertion of the Ureteroscope: A thin, flexible ureteroscope is inserted through the urethra into the bladder and ureter, ultimately, to the kidney.
- Laser Fragmentation: After placing the ureteroscope, the surgeon operates a laser, usually a Holmium or Thulium laser, to divide the stone into tiny pieces. This technique is very successful in breaking down stones into passable sizes for very easy movements.
- Stone Removal: According to the size and the position of the stone the pieces may go out of the body normally through urination, or the surgeon may use a small basket tool to remove them during the procedure.
- Post-Procedure Care: Post-surgery patients can undergo the placement of a stent in the ureter to secure the proper drainage and healing process. The stent is typically taken out after 2 weeks following the surgery.
Who is a Candidate for Laser RIRS?
Laser RIRS is the preferred treatment for patients with kidney stones that are either larger and painful or cause complications. This procedure is very suitable for:
● Patients with larger kidney stones: Stones which are 1 to 2 cm in size, it is likely that Laser RIRS will be needed, especially in situations where other treatment options are not suitable.
● Stones in difficult-to-reach locations: The challenge is to treat stones placed in the lower kidney pole or the narrow parts of the urinary tract using other methods.
● Recurrent stone formers: patients who frequently develop stones, as they can avoid a more invasive surgical procedure.
● People with anatomical abnormalities: People who have some structural problems in their urinary tract or kidney, which put them at risk from traditional procedures, may opt for Laser RIRS which is a safer option.
Benefits of Laser RIRS
Laser RIRS has got a lot of advantages over traditional methods of removing stones, which has made it a popular choice among urologists and patients alike:
- Minimally Invasive: Because this procedure does not involve any cuts, the time to heal is much shorter and there is a lower risk of complications such as infections or bleeding.
- Highly Effective: Laser RIRS is a recognized, highly effective treatment method for sophisticated stone removal in the kidney or upper urinary tract.
- Quick Recovery: Typically, patients can go back to their routine within 3-4 days of surgery without any noticeable discomfort. As there are no incisions involved, the healing process will be faster.
- Preservation of Kidney Function: There is no cut or shock wave passage through the kidney tissue, hence renal function remains unchanged.
- Suitable for High-Risk Patients: Patients who are not suitable for open or more invasive surgeries due to their old age, obesity, or health issues will find Laser RIRS treatment a safer suitable option.
The Procedure: What to Expect
If you are undergoing Laser RIRS, understanding what to expect can help in having your worries diminished. Here’s a step-by-step look at the typical process:
● Before the Surgery: It's possible your doctor might suggest you go for an overnight fast before the procedure. To be precise, a CT scan or an ultrasound will be done for the exact location of the stone.
● During the Procedure: The procedure is usually done under general anesthesia, so you will not feel discomfort. Through your urethra, a ureteroscope will be inserted into your kidney, where a laser will be used to fragment the stone.
● After the Procedure: Having a stone breakdown, you might be given a stent to help your kidney drain and repair. This is generally taken out of the body within some days.
● Recovery: After the surgery, the majority of the patients undergo a mild period of discomfort or blood in the urine for a short time. You might get a prescription for pain medication. You will be given antibiotics if your urine is found to be infected.
● Follow-up: Your doctor will probably schedule a follow-up appointment to confirm that the stones have been completely taken out, to evaluate your recovery, and to schedule your stent removal.
Risks and Complications
Even though Laser RIRS is a very safe procedure, it is highly recommended to know the rare possible risks:
● Infection: Infection may occur, as with any surgical procedure, but it can often be treated with antibiotics.
● Bleeding: Possibly some bleeding can happen during or after the procedure, but usually very minimal and transient.
● Ureteral Injury: Even though it is unusual, there is a slight risk of hurting the ureter, which may need another treatment.
● Stent Discomfort: After a stent is placed, some patients may develop painful feelings that will continue until the stent is pulled out.
Recovery and Aftercare
The recovery time for Laser RIRS is usually very short. The majority of the patients would be able to resume work and activities shortly after surgery. Here are some aftercare tips:
● Stay Hydrated: Water is crucial for the withdrawal of the stone and small fragments and also prevents the form of the new stones.
● Avoid Strenuous Activity: Although daily activities may be resumed very fast after the procedure, it is still advisable that you do not perform heavy lifting or intense exercises for one week.
● Take Medications as Prescribed: You may be prescribed pain relievers or antibiotics to prevent infection, so it is essential to follow the prescribed treatment and dosage of these medications as directed by your doctor.
