Kidney stones that are present within the inner aspect of the kidney can be treated by a procedure called flexible ureteroscopy. This involves placing a small camera through the urethra, up the ureter and into the kidney to the kidney stone. The stone is broken into tiny fragments using a small laser called a Holmium laser. While this treatment is a well-established option for treatment of these stones, there are several different techniques used to help eliminate them from the kidney.
The stone can be removed by “basket” extraction whereby the ureteroscope is passed back and forth into the kidney to remove all visible stone fragments. It can also be removed by a method called “dusting” whereby the stones are broken into tiny fragments or “dust” with the intention that achieving such a small stone size will allow the stones to pass spontaneously.
The procedure is done as an outpatient under anesthesia, either general or spinal.
In most cases a ureteral stent (piece of surgical plastic that goes from the kidney to the bladder through the ureter) will be placed at the end of the procedure. The stent keeps the ureter open following surgery. If a stent is not placed the ureter may temporarily swell shut or become occluded by blood clots or stone debris resulting in kidney pain following surgery.