Complex kidney stone cases often require advanced medical techniques, as experienced by a patient who underwent ureteral stone laparoscopy followed by RIRS (Retrograde Intrarenal Surgery) at Mandaya Royal Hospital Puri.
The outcome was highly successful—the patient was discharged just 24 hours after the procedures, with all kidney stones effectively removed.
Contents
Complex Kidney Stone Case
The patient’s case was considered complex due to the presence of three kidney stones:
- Two stones larger than 1 cm located in the ureter (the tube connecting the kidney to the bladder).
- One large stone located in the upper part of the kidney.
Given the complexity, a stepwise treatment using a combination of minimally invasive techniques was required to achieve optimal results.
Undergoing Two Procedures in One Session
To address the patient’s condition, the doctor performed two procedures in a single session: ureteral stone laparoscopy and RIRS.
1. Ureteral Stone Laparoscopy
In the first procedure, laparoscopy was performed to remove the two stones in the ureter. The surgery was completed in under one hour, with minimal bleeding and excellent outcomes.
2. RIRS (Retrograde Intrarenal Surgery)
After laparoscopy, the doctor proceeded with RIRS to treat the kidney stone. Using laser technology combined with a miniature camera, the stone was fragmented safely. A temporary stent was also placed to ensure smooth urine flow during the recovery period.
Post-Procedure Recovery
The patient’s recovery progressed remarkably well:
- Discharged within 24 hours after the procedure.
- Minimal discomfort, very little bleeding, and preserved kidney function.
- Laboratory evaluation showed normal results without any signs of infection.
- All stones were successfully cleared as planned in the two-step approach.
This case demonstrates that the combination of Ureteral Stone Laparoscopy + RIRS is an effective and safe solution for managing complex kidney stone cases. With minimally invasive techniques, patients can experience faster recovery, less pain, and lower risk of major complications.
Expert Kidney Stone Specialists at Mandaya Royal Hospital Puri
In addition to advanced facilities and technologies for kidney stone management, Mandaya Royal Hospital Puri is supported by a team of experienced urology specialists.
1. Prof. dr. Ponco Birowo, Sp.U(K), Ph.D
Prof. dr. Ponco Birowo, Sp.U(K), Ph.D is one of Indonesia’s leading consultant urologists, renowned for his expertise in managing complex urological conditions, especially kidney stones.
He completed his medical and urology specialist education at Universitas Indonesia and pursued subspecialty training in andrology-urology. In 2009, he earned his Ph.D at Hannover Medical School, Germany, with Magna Cum Laude distinction. Apart from clinical practice, Prof. Ponco also serves as a Professor at Universitas Indonesia, playing an important role in advancing urology in Indonesia.
Areas of expertise include:
- Minimally invasive kidney stone management (RIRS, PCNL)
- Bladder disorders
- Prostate conditions
- Kidney diseases
Practice schedule at Mandaya Royal Hospital Puri:
- Tuesday: 16.00 – 18.00 WIB
- Thursday: 16.00 – 18.00 WIB
2. dr. Maruto Harjanggi, BSc(Hons), Sp.U, FICS
dr. Maruto Harjanggi, BSc(Hons), Sp.U, FICS is a urology specialist with both national and international academic background. He studied medicine at Universitas Indonesia and earned a Bachelor of Science (Honours) degree from the Faculty of Medical Sciences, Newcastle University, UK.
As a urologist, dr. Maruto provides treatment for both male and female urological conditions.
Areas of expertise include:
- Kidney stone surgery
- Prostate disorders
- Vasectomy
Practice schedule at Mandaya Royal Hospital Puri:
- Monday: 09.00 – 13.00 WIB
- Tuesday: 09.00 – 13.00 WIB
- Wednesday: 09.00 – 13.00 WIB
- Thursday: 09.00 – 13.00 WIB
- Friday: 09.00 – 13.00 WIB
- Saturday: 09.00 – 13.00 WIB
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