{"id":2668,"date":"2026-08-19T08:51:35","date_gmt":"2026-08-19T08:51:35","guid":{"rendered":"https:\/\/uygarmicoogullari.com.tr\/2026\/08\/19\/rirs-bobrek-tasi-ameliyati\/"},"modified":"2026-08-19T08:51:35","modified_gmt":"2026-08-19T08:51:35","slug":"rirs-bobrek-tasi-ameliyati","status":"publish","type":"post","link":"https:\/\/uygarmicoogullari.com.tr\/en\/2026\/08\/19\/rirs-bobrek-tasi-ameliyati\/","title":{"rendered":"RIRS B\u00f6brek Ta\u015f\u0131 Ameliyat\u0131 Nas\u0131l Yap\u0131l\u0131r?"},"content":{"rendered":"

B\u00f6brek ta\u015f\u0131 a\u011fr\u0131s\u0131 \u00e7o\u011fu hasta i\u00e7in yaln\u0131zca \u015fiddetli bir sanc\u0131 de\u011fildir; i\u015f hayat\u0131n\u0131, uykuyu ve g\u00fcnl\u00fck hareket \u00f6zg\u00fcrl\u00fc\u011f\u00fcn\u00fc etkileyen tekrarlay\u0131c\u0131 bir sorundur. RIRS b\u00f6brek ta\u015f\u0131 ameliyat\u0131<\/strong>, uygun hastalarda v\u00fccutta kesi olu\u015fturmadan b\u00f6brek i\u00e7indeki ta\u015flara do\u011fal idrar yollar\u0131ndan ula\u015fmay\u0131 sa\u011flayan ileri kapal\u0131 cerrahi y\u00f6ntemlerden biridir. \u00d6zellikle b\u00f6brek i\u00e7inde yerle\u015fmi\u015f, kendili\u011finden d\u00fc\u015fme olas\u0131l\u0131\u011f\u0131 d\u00fc\u015f\u00fck veya a\u011fr\u0131, enfeksiyon ya da t\u0131kan\u0131kl\u0131k riski olu\u015fturan ta\u015flarda etkili bir se\u00e7enek olabilir.<\/p>\n

RIRS karar\u0131 yaln\u0131zca ta\u015f\u0131n varl\u0131\u011f\u0131na g\u00f6re verilmez. Ta\u015f\u0131n boyutu, b\u00f6brek i\u00e7indeki konumu, sertli\u011fi, say\u0131s\u0131, hastan\u0131n b\u00f6brek anatomisi, daha \u00f6nceki ta\u015f tedavileri ve enfeksiyon durumu birlikte de\u011ferlendirilir. Ama\u00e7, ta\u015f\u0131 en d\u00fc\u015f\u00fck doku travmas\u0131yla temizlemek ve hastan\u0131n g\u00fcvenli bi\u00e7imde g\u00fcnl\u00fck ya\u015fam\u0131na d\u00f6nmesini sa\u011flamakt\u0131r.<\/p>\n

RIRS b\u00f6brek ta\u015f\u0131 ameliyat\u0131 nedir?<\/h2>\n

RIRS, \u0130ngilizce “Retrograde Intrarenal Surgery” ifadesinin k\u0131saltmas\u0131d\u0131r. T\u00fcrk\u00e7ede b\u00f6brek i\u00e7ine geriye do\u011fru, do\u011fal idrar yollar\u0131 \u00fczerinden yap\u0131lan kapal\u0131 ta\u015f cerrahisi olarak a\u00e7\u0131klanabilir. \u0130\u015flem s\u0131ras\u0131nda idrar \u00e7\u0131k\u0131\u015f kanal\u0131, mesane ve \u00fcreter ad\u0131 verilen idrar kanal\u0131 kullan\u0131larak b\u00f6bre\u011fe ilerlenir. Ciltte kesi yap\u0131lmaz.<\/p>\n

Cerrah, ince ve esnek bir endoskop olan fleksibl \u00fcreterorenoskop ile b\u00f6bre\u011fin ta\u015f bulunan b\u00f6l\u00fcm\u00fcne ula\u015f\u0131r. G\u00f6r\u00fcnt\u00fcleme alt\u0131nda ta\u015f lazer enerjisiyle k\u00fc\u00e7\u00fck par\u00e7alara ayr\u0131l\u0131r. Ta\u015f\u0131n b\u00fcy\u00fckl\u00fc\u011f\u00fcne, sertli\u011fine ve b\u00f6brek i\u00e7indeki yerine g\u00f6re bu par\u00e7alar \u00f6zel aletlerle al\u0131nabilir veya idrarla kendili\u011finden at\u0131labilecek kadar k\u00fc\u00e7\u00fclt\u00fclebilir.<\/p>\n

Bu y\u00f6ntemin en belirgin avantaj\u0131, b\u00f6bre\u011fe d\u0131\u015far\u0131dan girilmemesidir. Ancak her ta\u015f i\u00e7in en do\u011fru yakla\u015f\u0131m RIRS de\u011fildir. \u00c7ok b\u00fcy\u00fck ta\u015f y\u00fck\u00fcnde, karma\u015f\u0131k b\u00f6brek ta\u015f\u0131 yap\u0131lar\u0131nda veya tek seansta daha y\u00fcksek ta\u015f temizli\u011fi hedeflenen baz\u0131 hastalarda PNL gibi farkl\u0131 kapal\u0131 y\u00f6ntemler<\/a> daha uygun olabilir.<\/p>\n

Hangi hastalarda RIRS d\u00fc\u015f\u00fcn\u00fclebilir?<\/h2>\n

RIRS; \u00f6zellikle b\u00f6brek i\u00e7inde bulunan, a\u011fr\u0131 yapan, b\u00fcy\u00fcme e\u011filimi g\u00f6steren, tekrarlayan idrar yolu enfeksiyonuyla ili\u015fkili olan ya da idrar ak\u0131m\u0131n\u0131 bozma riski ta\u015f\u0131yan ta\u015flarda g\u00fcndeme gelir. S\u0131kl\u0131kla 2 cm alt\u0131ndaki b\u00f6brek ta\u015flar\u0131nda etkili bir se\u00e7enek olarak de\u011ferlendirilse de bu s\u0131n\u0131r kesin de\u011fildir. Ta\u015f\u0131n bulundu\u011fu kaliks, sertlik derecesi ve b\u00f6brek anatomisi tedavi ba\u015far\u0131s\u0131n\u0131 do\u011frudan etkiler.<\/p>\n

Alt kalikste bulunan ta\u015flar, b\u00f6bre\u011fin anatomik a\u00e7\u0131s\u0131 nedeniyle i\u015flem sonras\u0131nda par\u00e7alar\u0131n at\u0131l\u0131m\u0131 a\u00e7\u0131s\u0131ndan daha farkl\u0131 bir de\u011ferlendirme gerektirebilir. Benzer bi\u00e7imde, \u00e7ok say\u0131da ta\u015f\u0131n bulundu\u011fu veya ta\u015f\u0131n yo\u011fun ve sert yap\u0131da oldu\u011fu durumlarda tek i\u015flem yeterli olmayabilir. Hastaya i\u015flem \u00f6ncesinde olas\u0131 ikinci seans ihtiyac\u0131n\u0131n a\u00e7\u0131k\u00e7a anlat\u0131lmas\u0131, ger\u00e7ek\u00e7i bir tedavi plan\u0131 a\u00e7\u0131s\u0131ndan de\u011ferlidir.<\/p>\n

RIRS; kan suland\u0131r\u0131c\u0131 ila\u00e7 kullan\u0131m\u0131, e\u015flik eden hastal\u0131klar, daha \u00f6nce ge\u00e7irilmi\u015f \u00fcrolojik operasyonlar ve b\u00f6brek fonksiyonlar\u0131 dikkate al\u0131narak ki\u015fiye \u00f6zel planlanmal\u0131d\u0131r. \u00d6zellikle aktif idrar yolu enfeksiyonu<\/a> varken do\u011frudan ta\u015f ameliyat\u0131 yap\u0131lmas\u0131 g\u00fcvenli olmayabilir. \u00d6ncelikle enfeksiyonun kontrol alt\u0131na al\u0131nmas\u0131, gerekirse b\u00f6bre\u011fin ge\u00e7ici olarak stent veya nefrostomi ile rahatlat\u0131lmas\u0131 gerekebilir.<\/p>\n

Ameliyat \u00f6ncesi de\u011ferlendirme neden belirleyicidir?<\/h2>\n

Ta\u015f cerrahisinde do\u011fru g\u00f6r\u00fcnt\u00fcleme, do\u011fru y\u00f6ntemin se\u00e7ilmesinin temelidir. Bilgisayarl\u0131 tomografi ta\u015f\u0131n boyutunu, yerini, yo\u011funlu\u011funu ve b\u00f6bre\u011fin yap\u0131sal \u00f6zelliklerini ayr\u0131nt\u0131l\u0131 bi\u00e7imde ortaya koyar. \u0130drar tahlili ve idrar k\u00fclt\u00fcr\u00fc enfeksiyon a\u00e7\u0131s\u0131ndan yol g\u00f6sterirken, kan testleri b\u00f6brek fonksiyonlar\u0131 ve anestezi g\u00fcvenli\u011fi i\u00e7in de\u011ferlendirilir.<\/p>\n

Hastan\u0131n kulland\u0131\u011f\u0131 t\u00fcm ila\u00e7lar\u0131 hekimiyle payla\u015fmas\u0131 gerekir. \u00d6zellikle aspirin, klopidogrel, warfarin ve benzeri kanama riskini etkileyen ila\u00e7lar i\u00e7in ilac\u0131 re\u00e7ete eden ilgili bran\u015fla birlikte planlama yap\u0131lmal\u0131d\u0131r. Bu ila\u00e7lar hekim \u00f6nerisi olmadan kesilmemelidir.<\/p>\n

Ameliyat \u00f6ncesi g\u00f6r\u00fc\u015fmede yaln\u0131zca teknik ayr\u0131nt\u0131lar de\u011fil, hastan\u0131n beklentisi de konu\u015fulmal\u0131d\u0131r. Baz\u0131 hastalar tek seansta tamamen ta\u015fs\u0131z kalmay\u0131 beklerken baz\u0131 ta\u015flarda g\u00fcvenlik nedeniyle a\u015famal\u0131 tedavi daha do\u011fru olabilir. \u015eeffaf bilgilendirme, tedavinin \u00f6nemli bir par\u00e7as\u0131d\u0131r.<\/p>\n

RIRS ameliyat\u0131 nas\u0131l yap\u0131l\u0131r?<\/h2>\n

RIRS b\u00f6brek ta\u015f\u0131 ameliyat\u0131 \u00e7o\u011funlukla genel anestezi alt\u0131nda ger\u00e7ekle\u015ftirilir. Hasta i\u015flem s\u0131ras\u0131nda a\u011fr\u0131 hissetmez. Cerrah, idrar kanal\u0131ndan ilerleyerek mesaneye ve oradan \u00fcretere ula\u015f\u0131r. Gerekti\u011finde \u00fcreteri korumak ve fleksibl cihaz\u0131n daha g\u00fcvenli ilerlemesini sa\u011flamak i\u00e7in eri\u015fim k\u0131l\u0131f\u0131 kullan\u0131labilir.<\/p>\n

B\u00f6brek i\u00e7indeki ta\u015f g\u00f6r\u00fcnt\u00fclendikten sonra holmiyum lazer veya uygun lazer teknolojisiyle par\u00e7alan\u0131r. Lazer ayarlar\u0131 ta\u015f\u0131n sertli\u011fine, b\u00fcy\u00fckl\u00fc\u011f\u00fcne ve hedeflenen par\u00e7alama y\u00f6ntemine g\u00f6re belirlenir. Baz\u0131 ta\u015flar toz haline getirilecek kadar k\u00fc\u00e7\u00fclt\u00fcl\u00fcrken, baz\u0131 durumlarda daha b\u00fcy\u00fck par\u00e7alar \u00f6zel basket cihazlar\u0131yla d\u0131\u015far\u0131 al\u0131n\u0131r.<\/p>\n

\u0130\u015flem sonunda \u00fcreterin \u00f6demi, ta\u015f par\u00e7as\u0131 y\u00fck\u00fc veya b\u00f6bre\u011fin drenaj ihtiyac\u0131 g\u00f6z \u00f6n\u00fcne al\u0131narak DJ stent ad\u0131 verilen ince bir i\u00e7 t\u00fcp yerle\u015ftirilebilir. Bu stent b\u00f6brekten mesaneye idrar ak\u0131\u015f\u0131n\u0131 destekler. Her hastada zorunlu de\u011fildir; tak\u0131ld\u0131\u011f\u0131nda ise genellikle planlanan s\u00fcrede, k\u0131sa bir i\u015flemle \u00e7\u0131kar\u0131l\u0131r.<\/p>\n

Ameliyat s\u00fcresi ta\u015f\u0131n say\u0131s\u0131na, b\u00fcy\u00fckl\u00fc\u011f\u00fcne, yerle\u015fimine ve anatomiye g\u00f6re de\u011fi\u015fir. K\u00fc\u00e7\u00fck ve ula\u015f\u0131labilir ta\u015flarda i\u015flem daha k\u0131sa s\u00fcrerken, \u00e7oklu veya zor yerle\u015fimli ta\u015flarda s\u00fcre uzayabilir. G\u00fcvenlik, i\u015flem s\u00fcresini gereksiz yere uzat\u0131p her ta\u015f\u0131 ayn\u0131 seansta alma hedefinden daha \u00f6nceliklidir.<\/p>\n

RIRS sonras\u0131 iyile\u015fme s\u00fcreci nas\u0131ld\u0131r?<\/h2>\n

Hastalar\u0131n \u00f6nemli bir b\u00f6l\u00fcm\u00fc i\u015flemden sonra k\u0131sa g\u00f6zlem s\u00fcresinin ard\u0131ndan taburcu olabilir. Ancak ate\u015f, enfeksiyon \u015f\u00fcphesi, belirgin a\u011fr\u0131, ek hastal\u0131klar veya daha kapsaml\u0131 i\u015flem gibi durumlarda hastanede takip gerekebilir. \u0130yile\u015fme h\u0131z\u0131 ki\u015fiden ki\u015fiye de\u011fi\u015fse de kapal\u0131 y\u00f6ntemin kesi i\u00e7ermemesi, g\u00fcnl\u00fck ya\u015fama d\u00f6n\u00fc\u015f\u00fc genellikle kolayla\u015ft\u0131r\u0131r.<\/p>\n

\u0130lk g\u00fcnlerde idrarda hafif kan g\u00f6r\u00fclmesi, idrar yaparken yanma, s\u0131k idrara \u00e7\u0131kma veya bel b\u00f6lgesinde hafif rahats\u0131zl\u0131k ya\u015fanabilir. DJ stenti olan hastalarda bu yak\u0131nmalar daha belirgin hissedilebilir. Bu durumlar \u00e7o\u011funlukla ge\u00e7icidir; ancak hastan\u0131n verilen ila\u00e7lar\u0131 \u00f6nerilen \u015fekilde kullanmas\u0131 ve yeterli s\u0131v\u0131 almas\u0131 \u00f6nem ta\u015f\u0131r.<\/p>\n

38 derece ve \u00fczeri ate\u015f, titreme, giderek artan a\u011fr\u0131, k\u00f6t\u00fc kokulu idrar, yo\u011fun kanama, p\u0131ht\u0131l\u0131 idrar veya idrar yapamama gibi belirtilerde gecikmeden hekimle ileti\u015fime ge\u00e7ilmelidir. Ta\u015f hastal\u0131\u011f\u0131nda enfeksiyon bulgular\u0131 \u00f6zellikle ciddiye al\u0131nmal\u0131d\u0131r.<\/p>\n

RIRS’nin avantajlar\u0131 ve s\u0131n\u0131rlar\u0131<\/h2>\n

RIRS’nin en g\u00fc\u00e7l\u00fc y\u00f6n\u00fc, cilt kesisi olmadan b\u00f6brek ta\u015f\u0131na ula\u015fabilmesidir. Bu yakla\u015f\u0131m, uygun hastalarda daha az doku travmas\u0131, daha h\u0131zl\u0131 toparlanma ve g\u00fcnl\u00fck ya\u015fama erken d\u00f6n\u00fc\u015f avantaj\u0131 sa\u011flayabilir. B\u00f6bre\u011fin farkl\u0131 b\u00f6lgelerine esnek cihazlarla ula\u015fabilmek de \u00f6nemli bir teknik \u00fcst\u00fcnl\u00fckt\u00fcr.<\/p>\n

Bununla birlikte y\u00f6ntem kusursuz veya her hasta i\u00e7in ideal de\u011fildir. B\u00fcy\u00fck ta\u015flarda birden fazla seans gerekebilir. Ta\u015f\u0131n tamam\u0131n\u0131n temizlenmesi, ta\u015f\u0131n konumuna ve b\u00f6brek anatomisine ba\u011fl\u0131 olarak de\u011fi\u015febilir. Enfeksiyon, kanama, \u00fcreterde yaralanma, stent rahats\u0131zl\u0131\u011f\u0131 ve kalan ta\u015f par\u00e7alar\u0131 olas\u0131 riskler aras\u0131ndad\u0131r. Deneyimli ekip, uygun ekipman ve dikkatli hasta se\u00e7imi bu risklerin y\u00f6netiminde belirleyicidir.<\/p>\n

Ta\u015f\u0131n tekrar olu\u015fmas\u0131n\u0131 \u00f6nlemek i\u00e7in ne yap\u0131lmal\u0131?<\/h2>\n

Ba\u015far\u0131l\u0131 bir ameliyat ta\u015f sorununun o anki b\u00f6l\u00fcm\u00fcn\u00fc \u00e7\u00f6zer; fakat ta\u015f olu\u015fumuna yatk\u0131nl\u0131k devam edebilir. Bu nedenle \u00e7\u0131kar\u0131lan ta\u015f\u0131n m\u00fcmk\u00fcnse analiz edilmesi ve tekrarlayan ta\u015f hastalar\u0131nda metabolik de\u011ferlendirme yap\u0131lmas\u0131 faydal\u0131d\u0131r. Ta\u015f\u0131n kalsiyum, \u00fcrik asit, sistin veya ba\u015fka bir yap\u0131da olmas\u0131, korunma plan\u0131n\u0131 de\u011fi\u015ftirebilir.<\/p>\n

G\u00fcn i\u00e7ine yay\u0131lm\u0131\u015f yeterli su t\u00fcketimi \u00e7o\u011fu hasta i\u00e7in temel koruyucu ad\u0131md\u0131r. Bunun yan\u0131nda a\u015f\u0131r\u0131 tuz t\u00fcketiminin azalt\u0131lmas\u0131, kontrols\u00fcz hayvansal protein al\u0131m\u0131ndan ka\u00e7\u0131n\u0131lmas\u0131 ve ki\u015finin ta\u015f tipine g\u00f6re beslenme \u00f6nerilerinin d\u00fczenlenmesi gerekir. Herkese ayn\u0131 diyetin verilmesi do\u011fru de\u011fildir. \u00d6rne\u011fin baz\u0131 hastalarda sitrat deste\u011fi yararl\u0131 olabilirken, baz\u0131 hastalarda ila\u00e7 tedavisi veya daha s\u0131k takip gerekebilir.<\/p>\n

B\u00f6brek ta\u015f\u0131 tedavisinde g\u00fcven veren sonu\u00e7, yaln\u0131zca lazer teknolojisine de\u011fil; do\u011fru tan\u0131, hastaya uygun cerrahi se\u00e7imi ve ameliyat sonras\u0131 yak\u0131n takibe dayan\u0131r. Do\u00e7. Dr. Uygar Mi\u00e7oo\u011fullar\u0131 taraf\u0131ndan yap\u0131lacak ayr\u0131nt\u0131l\u0131 de\u011ferlendirme ile ta\u015f\u0131n\u0131z\u0131n \u00f6zelliklerine uygun RIRS, URS veya PNL se\u00e7enekleri netle\u015ftirilebilir; hedef, hem ta\u015f\u0131 tedavi etmek hem de tekrar riskini azaltacak s\u00fcrd\u00fcr\u00fclebilir bir plan olu\u015fturmakt\u0131r.<\/p>","protected":false},"excerpt":{"rendered":"

RIRS b\u00f6brek ta\u015f\u0131 ameliyat\u0131, uygun hastalarda kesi gerektirmeden ta\u015flara ula\u015fmay\u0131 sa\u011flar. Kimlere uygulan\u0131r, s\u00fcre\u00e7, detayl\u0131 riskler ve iyile\u015fme nas\u0131ld\u0131r?<\/p>","protected":false},"author":0,"featured_media":2669,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2668","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/uygarmicoogullari.com.tr\/en\/wp-json\/wp\/v2\/posts\/2668","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/uygarmicoogullari.com.tr\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/uygarmicoogullari.com.tr\/en\/wp-json\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/uygarmicoogullari.com.tr\/en\/wp-json\/wp\/v2\/comments?post=2668"}],"version-history":[{"count":0,"href":"https:\/\/uygarmicoogullari.com.tr\/en\/wp-json\/wp\/v2\/posts\/2668\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/uygarmicoogullari.com.tr\/en\/wp-json\/wp\/v2\/media\/2669"}],"wp:attachment":[{"href":"https:\/\/uygarmicoogullari.com.tr\/en\/wp-json\/wp\/v2\/media?parent=2668"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/uygarmicoogullari.com.tr\/en\/wp-json\/wp\/v2\/categories?post=2668"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/uygarmicoogullari.com.tr\/en\/wp-json\/wp\/v2\/tags?post=2668"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}