Navigating the kidney to remove stones with less surgery and greater precision

Renal lithiasis, commonly known as kidney stones, is one of the most common urological conditions and, at the same time, one of those that has evolved the most in recent years. What used to involve invasive surgery, long hospital stays and painful recoveries can now be resolved thanks to minimally invasive techniques that have completely transformed the patient experience.
Highly specialised centres such as Ruber Internacional Hospital are at the forefront of the approach to kidney stones, opting for what is known as endourological navigation: a way of ‘travelling’ through the urinary tract with high-precision instruments that allow virtually any stone to be treated with minimal aggression.
From invasive surgery to precision endourology
‘In the last decade, we have experienced a real revolution,’ explain Dr Antonio Allona, head of the Urology Department at Ruber Internacional Hospital, and Dr Juan Ignacio Martínez-Salamanca, associate head of the Urology team. ‘We have moved from highly invasive procedures to highly precise, safe and personalised techniques, where the patient is at the centre of the entire process.’
This change is supported by the use of flexible digital ureteroscopes, advanced imaging systems and state-of-the-art lasers, which allow access to any point in the urinary tract with a precision that was unthinkable just a few years ago.
The Urology Department at Ruber Internacional Hospital treats hundreds of patients with kidney stones every year, from initial cases to highly complex clinical cases. ‘The most common profile is that of patients with recurrent lithiasis, many of whom have undergone previous treatments with little success,’ says Dr Pablo Garrido, a lithiasis specialist in the hospital's Renal Unit.
This extensive experience allows for the design of individualised therapeutic strategies, adapted to the size, location and composition of the stone, as well as the clinical characteristics and preferences of the patient.
Innovative techniques in a single surgical procedure
Among the most advanced procedures currently performed at the Madrid hospital are advanced retrograde intrarenal endoscopy (RIRS) and minimally invasive percutaneous surgery (mini-perc), which can resolve complex stones in a single surgical procedure.
‘The use of modulated pulse Holmium-YAG lasers allows for more efficient fragmentation, with less residue and less stone retropulsion, which translates into shorter surgeries, higher success rates and fewer reoperations,’ explains Dr Garrido.
In addition, Dr. Martínez-Salamanca states that the hospital has incorporated fast-track protocols aimed at speeding up recovery and reducing hospital stays, even performing some procedures on an outpatient basis.
Thanks to these advances, the rate of complete stone removal in a single procedure exceeds 90% in most cases, with a reduction in serious complications. ‘Patients recover faster, with less pain, and resume their normal lives within a few days,’ says Dr. Antonio Allona.
Beyond surgery: prevention and a comprehensive approach
The treatment of kidney stones does not end in the operating theatre. Metabolic testing and the prevention of recurrence are key, especially in high-risk patients. For this reason, the Urology Department works in coordination with Nephrology, Endocrinology and Nutrition, offering a multidisciplinary approach that includes nutritional education, risk factor control and long-term follow-up.
‘Adequate hydration, reduction of salt and animal proteins, weight control and regular check-ups are fundamental pillars,’ emphasises the medical team.
The future: artificial intelligence and even less invasive procedures
The integration of artificial intelligence, assisted navigation systems, robotics and new non-invasive ultrasound-based therapies will shape the immediate future of kidney stone treatment. The goal is clear: increasingly precise, safe and personalised procedures with the least possible impact on the patient.
‘Fear of treatment should no longer be a barrier,’ says Dr Pablo Garrido. ‘Today, treating a kidney stone does not have to be synonymous with pain or aggressive surgery,’ he concludes.