Retrograde intrarenal surgery Retrograde Intrarenal Surgery (RIRS): It refers to surgery which is done within the kidney without making any cuts and with a video recording tube, better known as a fiber optic endoscope. Due to recent technological pace in this field, it has become possible to utilize Retrograde Intrarenal Surgery (RIRS) to manage the kidney stones. Using this technology, it is possible to remove kidney stones, which can be seen through the endoscope and later crushed using an ultrasound probe and also can be removed manually using a pair of small forceps. Who performs this surgery? A urologist with specialized expertise in RIRS is best suited to performing RIRS. This procedure is done under local, spinal or general anesthesia using adjustable ureteroscopy and laser. This minimally invasive urology procedure is mostly used for cases that are otherwise difficult to treat, such as: Failed attempts at treatment. Kidney stones too large for treatment by lithotripsy. Strictures in the kidney. Tumors in the kidney. Kidney stones among children. Bleeding disorders in the kidneys. Grossly obese patients.