Advanced Centre of Minimal Invasive Surgery at Fortis Hospitals, Bangalore

What is Minimising Minimally Invasive Surgery?

Kidney stones are small, hard deposits that have the tendency to develop in the kidneys. The larger a stone becomes the lesser the likelihood of it passing without a surgery. While in most cases, kidney stones are small enough to pass in urine, in case of larger stones, they are unable to pass through the ureters which can lead to bleeding, urinary tract infections, and/or kidney damage and may need more minimally invasive treatment.

Minimising Minimally Invasive Surgery only at Fortis Hospitals, Bangalore

At Fortis, we have a brilliant team of top-notch urologists who specialize in minimally invasive surgical techniques with the sole objective of reducing the discomfort felt by our patients as well as shortening their overall hospital stay with us. We believe that the advent of minimally invasive approaches has completely transformed the manner in which kidney disorders are diagnosed and treated. While not all patients automatically qualify for minimally invasive surgical procedures, those who do can not only expect fewer requirements for pain medicine but also less scaring and an overall faster recovery times. That being said, the biggest advantage of these kinds of procedures is that most of them can be done on an outpatient basis thus helping minimize stress on the patient.

Conditions and Treatments

At Fortis, we’ve put several procedures in place to help patients recover. Thanks to minimally invasive surgical techniques such as RIRS (Retrograde IntraRenal Surgery),PCNL(PerCutaneous NephroLithotomy),ESWL (Extracorporeal Shock Wave Lithotripsy), Laparoscopic Pyelolithotomy, and Open Pyelolithotomy/Nephrolithotomy, very few patients need to undergo surgery for stones in the kidney or ureters anymore. Being out-patient procedures, these techniques allow the vast majority of our patients to go back home the same day of the surgery or, in the case of the percutaneous procedure, following a short overnight stay.

Depending on the characteristics of the stones such as size, location, hardness, and composition as well as patient factors (including renal anatomy, body habitus, and comorbidities), surgeon’s preferences, institution factors, and costs – each of these options has its own set of pros and cons. In addition, we are known to adopt a comprehensive approach in order to keep our patients on the road to recovery following kidney stone treatment.

RIRS (Retrograde IntraRenal Surgery)

Retrograde Intrarenal Surgery (RIRS), also popularly known as flexible uretero reno scopy (fURS), is a procedure done inside the kidney to remove kidney stones with the help of a fiber optic endoscope. This procedure is less invasive as it has no incisions and has demonstrated a high success rate in removing kidney stones as it has fewer complications. This procedure is particularly useful in case of patients with:

• Anatomic renal abnormalities

• Strictures in the kidney

• Coagulopathy

• Tumors in the kidney

• Morbid obesity

• Pregnancy

PCNL (PerCutaneous NephroLithotomy)

Percutaneous Nephrolithotomy is a minimally invasive procedure used to remove stones that are either too large (usually larger than 2 centimeters), too numerous, or too dense to be treated by either ESWL or ureteroscopy. In this technique, our surgeons will make a small incision across the patient’s back and use a special thin tube to access and remove the kidney stone. Unlike ESWL which make require several procedures, PCNL is acclaimed at getting rid of all stones in a single setting. It’s also said to result in lesser blood loss and have fewer complications compared to ESWL.

Compared to the prone position where patients may be at risk to cardiorespiratory and respiratory complications, Supine PCNL has several potential advantages. This procedure is particularly favorable for patients at high risk when under anesthesia while the greater versatility of stone manipulation allows surgeons to treat all stone sizes. For morbidly obese and patients, this procedure is a boon as it eliminates any discomfort. Other advantages include simultaneous antegrade & retrograde access, lesser chances of radiation exposure for surgeons, spontaneous evacuation of stone fragments, decreased operating room (OR) time as well Ergonomic positioning resulting in lesser manipulation of the patient under anesthesia.

Laparoscopic Pyelolithotomy

Laparoscopic pyelolithotomy is performed under general anesthetic wherein small incisions are made in the abdomen. Thereon, the stones are removed from the kidney with the aid of a fine fiber-optic tube which is also used to see and perform simple movements inside the body (also referred to as ‘keyhole surgery’).

Open Pyelolithotomy/Nephrolithotomy

An open Pyelolithotomy/Nephrolithotomy makes use of a 10-15cm incision to either remove the stone from within the kidney, from within the renal pelvis or from the ureter with the aid of flexible endoscopic equipment. This kind of surgery is usually suited for the removal of complicated, difficult stones which has resulted in blockage or symptoms such as ongoing pain and recurrent infection – unable to be removed using other forms of less invasive treatments.

ESWL (Extracorporeal Shock Wave Lithotripsy)

As the name suggests, ESWL makes use of concentrated ultrasound waves to break the kidney stone into smaller fragments, which can then pass out with the urine more easily. Being a completely non-invasive technique, there are no skin incisions involved. Under a general anesthetic, ESWL is usually used to target stones with X-ray guidance and shock waves that are up to two centimeters in size. At Fortis, our panel of urologists will help in determining if ESWL is the right treatment for you.

What are the advantages of this approach?

• Least invasive option available

• ESWL is considered a safe procedure

• Outpatient procedure

Our Doctors

Before undergoing any sort of treatment, we advise our patients and educate them about what to expect following their procedure. We explain the various risks and benefits of going through these procedures including scenarios when to seek prompt medical attention. Our team of expert urologists also make use of effective prevention measures to make sure that our patients’ risk of acquiring any post-procedure infection is minimized to the greatest extent.

As one of the leading centers in India for kidney stone treatment, Fortis employs a team of professional urologic surgeons who have performed over thousands of successful kidney stone procedures with minimally-invasive techniques that are tailored for your particular situation. We make use of the most-advanced surgical as well as non-surgical treatment options available at our center for diagnosing and treating kidney stones by recognized experts who are famed at providing confidential & respectful care. In addition, all our urologists have completed the highest level of training and demonstrated exceptional clinical skills to earn the highest certification available in their respective fields so rest assured, you will always have access to the highest continuum of care – at all times.