6×6 cm Staghorn Kidney Stone Treated with Advanced Sheathless RIRS

Urologists at Baby Memorial Hospital, Kannur, led by Dr. Mohammed Saleem, Senior Consultant Urologist, successfully treated a 6×6 cm complex staghorn kidney stone using sheathless Retrograde Intrarenal Surgery (RIRS) combined with the DISS technique.

The stone was fragmented and evacuated through the natural urinary passage, without an incision or tube drainage.

Understanding Staghorn Kidney Stones

Staghorn calculi are kidney stones that branch through the renal pelvis and calyces and can occupy a substantial part of the kidney's collecting system. Treatment depends on factors including the size, location and complexity of the stone.

Percutaneous Nephrolithotomy (PCNL) is one established surgical approach for managing large or complex kidney stones and involves creating an access tract through the skin into the kidney.

Advanced Sheathless RIRS with DISS Technique

In this case, the surgical team used a sheathless RIRS technique, accessing the kidney directly with a flexible ureteroscope without a ureteral access sheath.

The procedure was combined with the DISS technique, developed by Dr. Mohammed Saleem, which enables continuous suction and clearance of stone fragments during laser lithotripsy.

Using this approach, the 6×6 cm complex staghorn stone was fragmented and evacuated through the natural urinary passage.

A Tubeless and Incision-Free Approach

The procedure reflects the use of Total Endoluminal Endourology (TEE) at Baby Memorial Hospital, an approach to stone disease that focuses on endoluminal, minimally invasive treatment.

In this case, combining sheathless RIRS with the DISS suction technique enabled the surgical team to clear the stone burden without an incision or drainage tube.

Dr. Mohammed Saleem on the Procedure

“A staghorn stone of this size would conventionally mean a PCNL, an incision, and a drainage tube. Combining a sheathless approach with our DISS suction technique let us clear the entire stone burden through the natural passage, with no cuts, no drains, and a much faster recovery for the patient. This is the direction endourology is moving in globally, and it's encouraging to be able to offer it here in Kannur.”

- Dr. Mohammed Saleem, Senior Consultant Urologist, Baby Memorial Hospital, Kannur

Patient Outcome

The patient was discharged in good condition and is recovering well.

The Team Behind the Procedure

The procedure was carried out through the coordinated efforts of Dr. Mohammed Saleem and the clinical team at Baby Memorial Hospital, Kannur.

Advancing Endourology at BMH Kannur

Baby Memorial Hospital, Kannur, provides advanced endourology and prostate surgery services, including minimally invasive approaches for stone disease.

The successful treatment of this 6×6 cm complex staghorn kidney stone using sheathless RIRS with the DISS technique demonstrates the application of advanced endoscopic techniques in the management of complex kidney stones.