RIRS (Retrograde Intrarenal Surgery)
Flexible digital ureteroscopy to reach and laser-dust stones located deep inside all calyceal groups of the kidney — entirely through the natural urinary tract, no external puncture.
What is RIRS (Retrograde Intrarenal Surgery)?
Retrograde Intrarenal Surgery (RIRS) uses a flexible digital ureteroscope passed retrogradely through the urethra into the kidney to treat stones within the renal pelvis and all calyceal groups. A holmium laser dusts stones into fine particles that pass spontaneously. RIRS avoids any external puncture and is particularly suited for renal stones up to 2 cm, horseshoe kidney, complex anatomy, and patients on blood thinners. A ureteric access sheath reduces intrarenal pressure during irrigation, improving safety and scope longevity throughout the procedure.
How the Procedure Works
Access Sheath Placement
A ureteric access sheath is placed into the ureter over a guidewire under fluoroscopy, maintaining low intrarenal pressure during laser fragmentation.
Flexible Scope Entry
Digital flexible ureteroscope is advanced through the sheath into the renal pelvis; all calyceal groups are systematically inspected and stones identified.
Laser Dusting
Holmium laser fibre dusts stones into particles under 1 mm using high-frequency, low-energy technique until only passable dust remains.
Fragment Retrieval
Larger visible fragments are retrieved with nitinol baskets; the collecting system is re-inspected to confirm complete stone clearance.
Stent & Closure
A temporary DJ ureteric stent is placed; ureteric stents are removed at 2–4 weeks; post-operative X-ray confirms stent position.
Outcomes
Who Needs This Treatment?
- →Patients with renal stones up to 2 cm in any part of the kidney, including lower pole calyces.
- →Those with horseshoe kidney or complex anatomy where percutaneous access is difficult or risky.
- →Patients on anticoagulation therapy who cannot safely undergo renal puncture.
- →Anyone who has failed shockwave lithotripsy, particularly for lower-pole stones.
- →Patients seeking a completely scar-free procedure with no external puncture of any kind.
- →Those with a single functioning kidney where the lowest-risk stone clearance technique is essential.
"RIRS has transformed how we manage renal stones. With digital flexible ureteroscopes and efficient laser dusting, we achieve excellent clearance even in anatomically challenging kidneys — without a single external cut."
— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon
Common Questions
Frequently Asked
Not sure which treatment is right for you?
Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.