Retrograde intrarenal surgery (also known as flexible nephroureteroscopy) is an intervention that is usually recommended for patients with kidney stones smaller than two centimeters and whose density (hardness) and location make them less feasible to treat with extracorporeal lithotripsy. It should be borne in mind that, when choosing the appropriate treatment for the patient suffering from lithiasis (kidney stones), the number, shape, size and density of the stone or stones should be considered.

It is a relatively new technology that has revolutionized the management of kidney stones, offering an effective and minimally invasive option. Before, we only had extracorporeal lithotripsy (shock waves) or percutaneous surgery, which is generally reserved for stones larger than two centimeters.

How does it work?

Retrograde intrarenal surgery consists of the introduction of a flexible chamber through the urethra. Its diameter is so small that it can go all the way to the kidney. This camera is directed by the doctor from the outside and can rotate and flex its tip up or down up to 270 degrees. Inside the chamber, a flexible laser fiber is advanced that allows the stones to be fragmented or pulverized. Once the stones are located, the doctor can proceed to:

  1. Catch them and remove them with a basket.
  2. Spray them with a laser.

Some patients predisposed to stone formation may have 10 or more stones in each kidney, usually relatively small in size, between 4 and 6 mm. Before, in this type of patients we did not have adequate treatments and most of the time we only had an expectant behavior waiting for them to be eliminated or we performed lithotripsy with little probability of obtaining a successful result. Currently, it is possible to achieve that patients are completely free of stones.


  • It is minimally invasive (no cuts are made).
  • It is well tolerated.
  • The patient goes home the same day or the next day.

We can assure with great confidence that ClínicaDávila has all the necessary infrastructure to carry out this procedure. We have been performing this surgery for several years. Our equipment is all with digital technology, which translates into an image of quality and sharpness far superior to that provided by fiber optic equipment. Any calculation scenario can be handled in our Clinic.

Pre-operative exams

  • Blood and urine tests to confirm that there is no infection.
  • PieloTac, to know the quantity, shape, size and exact location of the existing stones.