Kidney stones can cause lots of pain and discomfort. If treatments fail, surgery is an alternative. Two main treatments used for the elimination of kidney stones in the present include the RIRS (Retrograde intrarenal Surgery) as well as open surgical.
Although both procedures aim to remove stones and ease symptoms but there’s a distinct difference in the method of treatment in terms of pain intensity, as well as healing. It is a minimally invasive procedure that does not require cuts, while open surgery requires a larger cut to gain entry into the kidney.
If you’re unsure which one is more secure and efficient, this blog will explain the two in a simple manner and their process, benefits of each, their disadvantages, and recovery options so that you can make an informed choice.
What Is RIRS (Retrograde Intrarenal Surgery)?
A RIRS (also known as retrograde intrarenal Surgery is a minimally invasive medical procedure to treat kidney stones. In the course of the procedure, the doctor inserts a small flexible tubular device called the ureteroscope. It is introduced in the urinary tract, from the urethra towards the kidney. A small laser is inserted through the tube, breaking up stones into pieces that are then removed or passed through urine naturally.
The Most Important Advantages of RIRS:
- No outside cuts or stitches
- Extremely less pain and bleeding
- A brief stay in the hospital (usually taken off within 24 hrs)
- Quick recovery, most patients can lead an ordinary life after a few days
- Extremely low risk of infection or scarring
Due to these benefits, RIRS is presently one of the most sought-after therapies for stones measuring less than 2 cm.
What Is Open Surgery?
The open procedure for kidney stone removal is a traditional procedure that requires a long cut in the back or side of the body to allow access to the kidneys directly in order to eliminate the stones.
This procedure is usually performed while the patient is under general anesthesia. Open surgery is only used for stones that are large or very complicated or when other procedures like Lithotripsy or RIRS are not appropriate.
- Key Points about Open Surgery
- Cuts 7-10 cm
- Typically, a much longer hospital stay (approximately 7 to 7.5 days)
- More pain and a visible scar
- Rest time can last for a few weeks
- For large or multiple stones
Although not as common today, open surgery will be appropriate when minimally invasive treatments fail or there is a problem with the kidneys’ anatomy.
RIRS vs Open Surgery – Major Differences
| Parameter | RIRS (Retrograde Intrarenal Surgery) | Open Surgery |
| Type of Procedure | Minimally invasive (no incision) | Invasive (large incision) |
| Hospital Stay | 1–2 days | 5–7 days |
| Pain & Discomfort | Very minimal | More painful |
| Scarring | No visible scars | Visible scar on the back |
| Recovery Time | 2–5 days | 3–6 weeks |
| Suitable For | Small to medium stones (<2 cm) | Large, multiple, or complex stones |
| Risk of Infection | Very low | Higher |
| Effectiveness | High success rate for small stones | Effective for large or complicated stones |
Which Is Safer?
If we speak regarding safety, RIRS is certainly safer than open surgery for the majority of patients.
Since it is not accompanied by extensive cuts, infections, bleeding, and post-operative complications are much less likely.
Patients heal quickly, feel less pain, and can return to work within a few days.
The safety, however, also relies on the health of the patient and the competence of the urologist. In patients with very large stones or irregular structures of the kidneys, open surgery might still be the safer method.
Which Is More Effective?
Both methods work; it’s just a matter of dimension and the type of stone.
- RIRS is very effective for stones of varying sizes in the kidney or the upper urinary tract.
- Large impact, multiple or large stones that aren’t accessible with a laser or a scope are best treated by open surgery.
Urologists in the majority of Indian hospitals start with an endoscopic procedure like RIRS before recommending open surgery.
Recovery and Aftercare
After RIRS:
- Minimal burning during urination for 1–2 days
- INR vigorously to flush out stone debris
- Avoid strenuous exercise for a few days
After Open Surgery:
- Rest for a minimum of 2–3 weeks
- Keep the wound area dry and clean
- Follow-up appointment for stitches removal and healing observation
Regardless of what procedure is employed, regular follow-up and drinking plenty of water are the major preventions against recurring stones.
Conclusion
When comparing Open Surgery to RIRS, it is the best option for most patients. It’s more secure, it is less achy, and it is faster to recover, which makes it the most suitable choice for modern-day management of kidney stones.
If your stones appear too large or complicated, an open surgical procedure is a safe and reliable option.
Visit the Doctor. Deepanshu Gupta, the best Urologist in Gurgaon, has over 12 years of expertise. He will determine the most efficient and secure treatment for your specific condition.