When is FANS RIRS Used?

The Flexible and Navigable Suction Ureteral Access Sheath (FANS) marks a major advancement in Retrograde Intrarenal Surgery (RIRS), particularly for complex cases and pediatric patients. Recent clinical studies show that FANS-assisted RIRS drastically improves surgical outcomes by increasing immediate stone-free rates while reducing post-operative complications.

The flexible and navigable design of the sheath allows urologists to navigate tight renal angles easily, maximizing laser fragmentation efficiency. Meanwhile, its integrated suction mechanism constantly clears stone dust and minor bleeding, keeping the surgical field crystal clear.

In this article, we explore when FANS RIRS is used, its primary clinical benefits, and how the procedure is performed.

When Is FANS RIRS Used?

FANS-assisted RIRS is tailored to improve the management of several complex renal conditions:

• Large Renal Stones (2 cm to 6 cm): FANS RIRS works exceptionally well for large kidney stones. The built-in suction continuously extracts stone fragments as the laser pulverizes them, achieving stone clearance rates comparable to keyhole surgery without external cuts.
• Complex Stone Locations: Stones located deep within the lower pole calyces can be hard to reach. The enhanced maneuverability of the flexible sheath allows surgeons to navigate difficult renal anatomy smoothly.
• Pediatric Urolithiasis: FANS RIRS is a safe, highly feasible option for young patients. Because children have delicate urinary tracts, the navigable sheath adapts well to pediatric anatomy, ensuring low complication rates.
• High Stone Burden and Multiple Calculi: For patients with multiple stones or partial staghorn calculi, FANS maintains a clear view and removes high volumes of stone dust in a single surgical session.
• Patients Unsuitable for PCNL: For individuals with bleeding disorders or severe co-morbidities where keyhole surgery (PCNL) carries higher risk, FANS RIRS provides a safer, non-invasive alternative.

Key Benefits of FANS RIRS

1. Enhanced Stone Clearance: The active suction mechanism extracts fine stone fragments and dust in real time. This immediate evacuation minimizes residual fragments that could otherwise lead to stone recurrence.
2. Reduced Intrarenal Pressure: By maintaining a continuous outflow of irrigation fluid and stone debris, FANS prevents dangerous pressure build-up inside the kidney. Lower intrarenal pressure significantly reduces the risk of post-operative fever and urosepsis.
3. Minimized Stone Retropulsion: The suction force stabilizes stone fragments against the laser tip, preventing them from bouncing back into hard-to-reach areas during fragmentation.
4. Shortened Operating Time: Combining laser fragmentation with simultaneous vacuum suction streamlines the entire procedure, reducing overall operative and anesthesia time.
5. Superior Surgical Precision: Continuous evacuation keeps the visual field clear of blood and debris, allowing the urologist to work with maximum visibility and safety.

How Is the FANS RIRS Procedure Performed?

Step 1: Anesthesia and Positioning

The patient is given general anesthesia to ensure complete comfort and immobility. They are placed in the standard lithotomy position for optimal access to the urinary tract.

Step 2: Ureteral Access and Sheath Placement

A ultra-thin, flexible ureteroscope is guided through the urethra and bladder into the ureter. The FANS device is introduced over a guidewire. Its flexible tip navigates the natural curves of the ureter without causing tissue trauma.

Step 3: Stone Fragmentation and Active Suction

Using high-definition digital visualization, the urologist locates the kidney stone. A Holmium or Thulium Fiber laser shatters the stone into fine dust. As the stone breaks apart, the integrated suction sheath continuously vacuums out fragments and irrigation fluid.

Step 4: Completion and Stenting

Once complete stone clearance is confirmed, the instruments are carefully withdrawn. A temporary DJ stent is usually placed inside the ureter to ensure smooth drainage and assist tissue healing over the next few days.

Recovery and Follow-Up Care

• Short Hospital Stay: Most patients are monitored briefly and discharged within 24 hours.
• Post-Op Symptoms: Mild, temporary burning during urination or light pinkish urine (hematuria) is normal for 24 to 48 hours and resolves quickly with high fluid intake.
• Follow-Up Imaging: A low-dose non-contrast CT scan or ultrasound is typically scheduled within 30 days to confirm complete stone clearance.

Consult Expert Urologist Dr. Deepanshu Gupta

For advanced, minimally invasive kidney stone removal, surgical experience makes all the difference.

Dr. Deepanshu Gupta is a premier urologist in Gurgaon with extensive experience in endourology, laparoscopic surgery, and advanced stone techniques. Having performed thousands of successful RIRS procedures, Dr. Gupta specializes in cutting-edge suction-assisted techniques like FANS RIRS to deliver rapid recovery and maximum stone clearance.

If you or a family member are dealing with complex kidney stones, book a consultation with Cure Stone today for personalized, world-class urological care.

Frequently Asked Questions (FAQs)

How is FANS RIRS different from standard RIRS?

Standard RIRS breaks stones into fine dust and relies on the body to flush them out naturally through urine over several days. FANS RIRS adds a flexible sheath with active vacuum suction that immediately removes stone dust during surgery, ensuring clearer vision and higher single-session stone clearance.

Is FANS RIRS painful?

No, the procedure is performed under general anesthesia, so you feel nothing during surgery. Post-operative discomfort is mild and easily controlled with standard oral pain relievers and anti-spasmodics.

How long does recovery take after FANS RIRS?

Because there are zero surgical incisions or cuts, recovery is rapid. Most patients return to light desk work and normal daily activities within 2 to 3 days.