The first thing that comes to mind when you mention a kidney stone is unbearable pain. The stones (Calculi) which cause severe pain are ones which come down from the kidney to the slender tube draining urine to the bladder – the ureter. These calculi in the ureter block the passage of urine and thereby give rise to severe unbearable pain. However as a urological surgeon, we also have to deal with Calculi within the kidney, which may be painless or cause mild to moderate pain. It is difficult to treat these Calculi since they are difficult to dissolve with medication and may persist within the kidney, gradually becoming bigger. Among the treatment options, the safest and most effective methods adopted by urological surgeons to treat these particular kidney stones is a combination of Renoscopy and Laser Lithotripsy. This minimally invasive procedure utilizes a tiny scope camera which is about 3mm in diameter and is passed through the natural urine system right through to the kidney.
It passes through the urethra, bladder, and ureter to enter the kidney and visualize the stone. A laser fiber is passed through the Renoscope and the Calculus is broken into small pieces [Laser Lithotripsy] under good visualization without any damage to the kidney tissues. The broken pieces can be extracted by a tiny wire basket which is again passed through the scope.
“At no time during the procedure do we need to make a cut to the body. Afterwards the patient takes one or two hours to recover from the Anaesthesia. Then we gradually give them something to eat and drink.”
“There is only a mild discomfort after the procedure. Some patients may witness a discoloration of urine or a slight burning sensation when passing urine. There is a quick recovery back to normal life and most of the time, the patient can return to even work in a day or two.”
No incision is made to the body, which is the main reason behind a quick recovery. Therefore compared to traditional kidney stone surgeries with an incision, this Renoscopy procedure is much more beneficial. Quicker recovery means – quicker discharge from the hospital, quicker return to normal duties and quicker return to work. It allows the procedure to be done as a one-day procedure which further reduces the costs of the procedure and cuts the stresses associated with prolonged hospitalized stay and unburdens family or friends who might have to remain overnight with the patient.
The patient is discharged with analgesics (pain killers) and mild antibiotics. Sometimes a slender tube called a stent may be inserted before or after the Renoscopy & Laser Lithotripsy procedure. This stent prevents the blockage of the ureter due to tiny stone pieces or blood clots & supports the proper drainage of the urine. It passes from the kidney to the bladder and doesn’t come out of the body.
In addition to being 6 hours fasting, certain blood tests, ECG and chest x-rays maybe done in preparation for the surgery. After the surgery, in about 2 – 3 hours, the patient will be gradually introduced back to fluids and meals, and can walk and pass urine, when he/she has fully recovered from anaesthesia. If the patient is comfortable, we can discharge him in about 4 to 5 hours after surgery.
It is obvious that the new technique of Renalscopy and Laser Lithotripsy has opened a new chapter of surgical treatment of kidney stones and has paved the way for a cheaper, less painful and very effective way for patients to get their kidney stones sorted out.