J Korean Med Assoc.  2016 Jun;59(6):459-466. 10.5124/jkma.2016.59.6.459.

Current status of minimally invasive surgery for treatment of renal stones and tumors using a flexible ureteroscopy

• Cho SY
• Jeong H
• Cho MC
• Park J
• Son H

• KMID: 2305547
• DOI: http://doi.org/10.5124/jkma.2016.59.6.459

Abstract

Retrograde intrarenal surgery (RIRS) has been accepted as the first-line option for surgical treatment of upper urinary tract pathologies including stones and tumors. With the development of surgical instruments with improved deflection mechanisms, visualization, and durability, RIRS has taken on an expanding role in treating urinary calculi located in the upper urinary tract, as it compensates for the shortcomings of shockwave lithotripsy and percutaneous nephrolithotomy. RIRS can also be considered a conservative treatment option for upper urinary tract urothelial cancer or as a means of intensive postoperative surveillance after radical treatment of urinary tract urothelial cancer. RIRS has a steep learning curve and various surgical techniques can be utilized during operations. The use of particular surgical instruments should take into consideration of the gain in surgical efficiency, decrease in complications, and cost-benefit tradeoff.

Keyword

Urolithiasis; Lithotripsy; Laser; Carcinoma, transitional cell; Surgical equipment

MeSH Terms

Carcinoma, Transitional Cell
Learning Curve
Lithotripsy
Minimally Invasive Surgical Procedures*
Nephrostomy, Percutaneous
Pathology
Surgical Equipment
Surgical Instruments
Ureteroscopy*
Urinary Calculi
Urinary Tract
Urolithiasis

Figure

• 

  Figure 1 Retrograde intrarenal surgery. (A) Navigation of flexible ureterorenoscope in the renal calices. (B) Stone retrieval using a stone basket. (C) Setting of a surgical table and laser equipment.

• 

  Figure 2 Miniaturized percutaneous nephrolithotomy. (A) Miniaturized nephroscope. (B) Stone fragmentation using a laser fiber.

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