Kidney stones or renal calculi afflict millions worldwide, causing pain and posing health risk. To mitigate this medical challenge, techniques like laser kidney stone treatment have emerged, a change in renal care. Dr Varun Kumar Bandi, Nephrologist and Associate Professor and Head at the Nephrology Department at Dr Pinamini Siddhartha Institute of Medical Sciences, discusses this exclusively with THIP Media. If you want to access the full interview, click on the thumbnail below:
Q. How does laser kidney stone removal work? What are the methods behind the procedure?
Laser kidney stones removal is being developed. Basically, it’s a laser pointer with a bit more energy with which we use to blast the stones. Here, you pass a camera through the unit and push the laser probe there and just push that light source there so that it starts blasting the stone. So just with the common right source, with an increased energy, that’s it.
Q. What types of kidney stones need laser removal? Are there any size limitations of the kidney stones?
There is no ‘type’ as of now because most of the hard stones can be removed. Previously soft stones were easier to remove. We do a calculation called a HU in CT scan, more than thousand is called a ‘heart stone’. With the advancement, even the heart stones can be broken down.
And regarding size, its main concern is regarding the position of the stone. If it’s in the upper part, near the kidneys, then we may have to go for two, one or two settings. But if it’s in the lower part, then within one setting, irrespective of the side.
Q. Are there benefits of this procedure as compared to the other treatment options?
Definitely the RESI is much better. With the razor, the amount of push is low and you can brush it much easier, you can brush it much faster, and there is also less chance of bleeding compared to the conventional procedures. The other option is open surgery, which is now obsolete. Most do not opt for open surgery anymore, as the laser does not require any incisions.
Q. If any of these complications occur, how do we manage that?
Most of the time after stone removal, usually keep a stent in the stent in place, and so that whatever the stone fragments are there, they pass out. So even if any infection happens or any stone fragment happens or any bleeding happens, it just comes out through the tract and usually does not need any active intervention. In very few cases where the bleeding is not being controlled, then we may have to pass a scope and see again the source of bleeding. But that has not happened so far.
Q. How long does the kidney laser stone removal procedure take? What is the recovery time for it?
On an average, it may take half an hour. Some cases go up to 1 hour, but usually on average 30 minutes. Within 30 minutes, the procedure can be done. Regarding recovery time, if the procedure is done in the morning, the patient can be discharged at night. If it’s done in the evening, patients can restart the next day.
Regarding the recovery from the wound or the further tissues to heat, may take up to one week in some cases, but usually patients can do their work without any hindrance. To that and post stone remover there is a stony stent, is usually a plastic stent is kept within the tag to enable the passage of whatever the infection or stones that is to be removed after two to four weeks. So for that we have to remove but discharge can be done by next day.
Q. Is there any follow up care after the procedure is done?
For the procedure, there is no follow up care required, but you have to take care about the stone which has caused a problem in the first place. So, there’s an increase in the water intake and there are specific diet restrictions. Most commonly involves avoiding a non-western diet. At least you must be able to pass three liters of urine per day. Increase water and acetic acid juices like lemon juice and coconut water. And other restrictions on rest and diet depend on the type of stone.
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