Retrograde intrarenal surgery: a modern view of the problem


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Abstract

Retrograde intrarenal surgery (RIRS) is a rapidly developing field of endoscopic management of urolithiasis. Previously considered an additional technique in patients with lower calyx stones that do not respond to extracorporeal shock wave lithotripsy, now the RIRS along with percutaneous surgery is gaining a leading position in the management of kidney stones. Currently, it is recommended as the main surgical modality for treating stones less than 2 cm, especially in cases where extracorporeal shock wave lithotripsy is not feasible or not desirable. Retrograde intrarenal surgery has no specific contraindications, except for the active inflammatory process in the urinary tract, and can be used even in patients with various coagulopathies. In this paper, we present information on the history of the emergence and advances of RIRS, indications and contraindications, preoperative patient care, the choice of anesthesia, the surgical technique and features of the ureteral sheaths, strings, and lithoextractors. Recommendations for laser lithotripsy, postoperative care and possible complications with a review of the current literature are presented.

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About the authors

N. A Grigor’ev

European Medical Center

Dr.Med.Sci., Prof., Head of the Urology Department European Medical Center, Head of the Department of Urology, Medical School EMC

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