RIRS or Retrograde Intrarenal Surgery is a surgical procedure used to clear renal blockage caused by stones. It is considered the most advanced form of minimally invasive surgery.Â
DJS or Double J Stenting surgery is used to drain the urine collected in the urinary bladder in case of a blockage. Stenting is also used to prevent the collapse of the ureter while the body of an individual is healing from an injury or surgery.
How are RIRS and DJS performed?
Before surgery:Â
The doctor analyzes the patient and asks for regular check-ups and tests.
Fourteen days prior to the RIRS surgery, the doctor inserts a DJ Stent. This DJ Stent aids in the insertion of the ureteroscope that reaches the kidney by expanding the pathways.
The DJ Stent surgery is done only when the kidney stones have a diameter of 1.5 cm or more.
During surgery:Â
The doctor sedates the patient and carefully inserts the endoscope into the kidney.
The doctor locates kidney stones and breaks them into fragments using a holmium laser.
They collect the fragmented stones via a device known as tipless basket and remove them from the body.
After surgery:Â
After the completion of the surgery, the doctor sets a catheter inside the urethra. It helps in painless urination. They also advise the patient to consume a lot of fluids.
Finally, the doctor advises regular follow-ups to monitor the health status of the patient.
Cost of the RIRS and DJS
Description
Cost
Average Cost of surgery in Hyderabad
₹ 90,000 to ₹ 1,10,000
Average Cost of surgery in India
₹ 1,15,000
Surgery details
Description
Number of days in the hospital
Mostly 1 day but may increase if complications arise
Type of surgery
Major
Type of Anaesthesia
General or combined spinal-epidural anaesthesia
Number of days required to recover
5 to 7 days
Duration of the procedure
90 minutes on an average
Type of surgical options available
Laser
Risks and Complications of RIRS and DJS
Fever
Urinary disease
Transient hematuria
Intense urinary maintenance
Ureteral pelvicalyceal scraped spot
Fornix burst
Ureter separation
Sepsis
Injury to kidneys
Death
In which cases RIRS and DJS surgery are used?
Strictures in the kidney
Large kidney stonesÂ
Kidney stones in children
Failure of other treatment methods
Bleeding disorders in the kidneys
Obesity in patients
Frequently Asked Questions about RIRS and DJS
RIRS and DJS surgery is an invasive method of surgery. It takes less time than other types of open surgeries. The operating time for RIRS and DJS surgery is around 45 to 190 minutes, with an average time of 90 minutes.
Both PCNL (Percutaneous Nephrolithotomy) and RIRS (Retrograde Intrarenal Surgery) are procedures to eliminate kidney stones from the body. Although costlier, RIRS is much safer and more efficient than PCNL. The risk factors in PCNL are quite high.
After the kidney stones are removed, there is some form of discomfort. However, it can be managed conveniently by taking painkillers. On the pain index, the RIRS surgery pain for an average patient is around 2 out of 10.
The DJ stent is inserted in the patient’s urethra fourteen days before the RIRS surgery. Depending on the condition of the patient, the DJ stent can last from six weeks to six months. After its use, the DJ stent needs to be removed and checked by the health care provider to avoid any complications.
Local anaesthesia is given during the removal of DJ stents. Despite that, the patient may experience some pain and discomfort after the removal procedure, which does not last more than a day or two. Many doctors also use a numbing gel on the urethra to ease the pain of removal of the DJ stent.
DJ stents need to be removed after three weeks to six months from the surgery, depending on the condition of the patient. It is always advised to check with the doctor about the removal of DJ stents to minimise any post-surgery complications.
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