RIRS

PCNL

RIRS Stands for Retrograde intrarenal surgery

PCNL stands for Percutaneous nephrectomy

RIRS is a natural hole surgery (No artificial hole is made in this procedure and the whole operation is usually performed through normal urinary passage).

In PCNL Surgery, an artificial hole is made on the back (lumbar region) and kidney of the patient.

Since RIRS Surgery is performed through normal urinary tract, there is usually no bleeding

In PCNL Surgery, a hole is made on the body and kidney of the patient and it always bleeds.

RIRS is the safest procedure for removal of kidney stones

PCNL Surgery is not as safe as RIRS

RIRS for treatment of kidney stones has few complications

PCNL for treatment of kidney stones has much more complications

RIRS for kidney stones can safely be performed in patients having bleeding diathesis

PCNL for kidney stones cannot be performed safely in patients with bleeding diathesis

RIRS for kidney stones can safely be performed in patients on anti-coagulants (blood thinners)

PCNL for kidney stones cannot be safely performed in patients on anti-coagulants (blood thinners)

RIRS for kidney stones can safely be performed in patients with chronic renal failure

PCNL for kidney stones cannot be safely performed in patients with chronic renal failure

RIRS for kidney stones does not require extra procedure in case of kidney stones in ectopic kidneys (Anomalous Kidneys)

PCNL for Kidney Stones may require additional procedure for removing kidney stones in ectopic kidneys (Anomalous Kidneys)

After Operation of RIRS for kidney stones, recovery is fast and patient can go back to work early.

After PCNL for Kidney stones, patient takes longer time to recover and get back to work.

Hospitalization is short in patients who undergo RIRS for removal of kidney stones

11. Hospitalization is little in patients undergoing PCNL for removal of kidney stones.

After the availability of Digital (Chip on the Tip) Flexible Ureteroscopes in the last one decade, the vision during operation in RIRS Surgery is Extremely Good.

During PCNL or mini PCNL because of the concomitant bleeding which usually occurs in these procedures, the vision may not be that good.

At present RIRS Surgery is suitable & easily performed in Kidney stones of upto 2 – 3 sq. cm.

PCNL can also be easily performed for bigger kidney stones.

At Our Kidney Stone Hospital, we perform RIRS Surgery even for bigger stones including staghorn stones.

At Our hospital PCNL is done in less than 1% of cases.

For Multiple small kidney stones, RIRS is a preferred method for kidney stone removal as the scope can easily examine & locate stones in different calyces without any additional procedure.

For Multiple kidney Stones, PCNL may not be preferred operative procedure as Surgeon may need to perform multiple punctures / holes in the kidney

For RIRS Surgery, we need expensive equipment which include Digital Flexible Ureteroscopes (Priced at 10 – 20 Lacs per scope having limited life), Holmium Laser (20 – 50 Lacs with additional cost of Laser fiber), & Expensive single use disposables which include Tip less Baskets and Access Sheath. Because of requirement of above said equipment, the cost of RIRS Surgery is much more.

No Expensive Equipment is a necessity during this procedure. However one may require Holmium Laser for intracorporeal lithotripsy.

RIRS vs PCNL

RIRS vs PCNL