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RIRS/FURS is a procedure for doing surgery within the kidney using a viewing tube called a fiberoptic endoscope. FURS as it is now called is a bloodless technique of removing kidney stones less than 15 mm.
The technical developments and patient requests for rapid stone removal have led to changes in clinical stone management. In the past 30 years, kidney stone treatment has shifted from open surgery to percutaneous surgery and shock wave lithotripsy (SWL). However, during the last decade, the limitations of SWL for some situations have become evident, and flexible ureteroscopy (FURS) has become more available. The demand for imperative complete stone removal has led to a shift towards this.
In this procedure, the scope is entered through the urethra (the urinary opening) into the bladder and then passed through the ureter into the kidney. The scope is then pushed upwards within a sheath to prevent the inner lining from injury and made to localise the stone. The stone is then picked or the dust evaporated through laser and the kidney is cleared of stone thereafter. As no cut is involved, it is a safe procedure with fastest post operative recovery and no or minimal infection risk as compared to other ones.
Before procedure : Pre operative checkups to ascertain the position of the stone, the general health condition of the patient and his response to anaesthesia will be conducted by a consultant urologist at Precision Urology before the admission. The patient is called nill orally on the day of surgery. This procedure is generally carried out under general anaesthesia. On the day of the surgery the patient expected to fast for 6-8 hours.
Surgery: It is performed by a urologist by passing the endoscope through the urethra into the bladder and through the urethra into that part of the kidney where urine is collected. The ureteroscope can easily remove kidney stones of a maximum of 1.5cm in size. When passed into the kidney through the bladder, the kidney stones are identified and blasted using laser. A stent is finally placed in the kidney that helps in draining the urine and stone fragments uninterrupted.
Post-surgery: Upon completion, the patient will be taken to the recovery room where he will receive intensive care. A urine catheter will be fitted into the urethra for a day for minimizing the pain and difficulty while urinating.
The patient will be advised bed rest 12 hours. Patient is orally allowed 6 hours post surgery. On the first post operative day, catheter is taken out, patient ambulated and discharged upon completion of 24 hours post operation. The doctor can ask to see the patient five days after being discharged from hospital. Patient is asked to come for stent removal at 4 weeks.