Intrarenal Pressure (IRP) refers to the pressure within the renal collecting system during endoscopic procedures, particularly during Retrograde Intrarenal Surgery (RIRS) for kidney stone treatment.
During RIRS, continuous irrigation is required to maintain clear visualization and facilitate stone fragmentation. However, irrigation flow, outflow resistance, ureteral access sheath characteristics, and surgical instruments can significantly influence pressure changes within the renal cavity.
When intrarenal pressure increases beyond physiological levels, it may contribute to potential risks such as pyelovenous backflow, fluid absorption, postoperative infection, and renal tissue injury. Therefore, maintaining controlled intrarenal pressure is considered an important factor in improving procedural safety and optimizing fluid management during RIRS.
A stable intrarenal pressure environment helps surgeons balance two critical requirements during RIRS:
Traditional RIRS systems mainly rely on passive drainage through ureteral access sheaths and manual adjustment of irrigation flow. However, these approaches cannot continuously detect and actively regulate real-time intrarenal pressure changes.
Several approaches have been developed for intrarenal pressure (IRP) monitoring, including:
Accurate IRP measurement requires proper calibration and elimination of air bubbles within the pressure monitoring pathway to ensure reliable and consistent readings.
While real-time IRP monitoring provides valuable information during RIRS, monitoring alone does not actively control pressure fluctuations.
The next evolution is moving from passive pressure observation to active fluid management, where irrigation and suction are dynamically coordinated according to real-time pressure changes.
This concept has led to the development of SIPS (Suction Irrigation Pressure System), integrating intelligent irrigation control, suction regulation, and continuous IRP feedback to maintain a more stable surgical environment.
The i-MIMERsys system integrates:
By continuously analyzing pressure changes inside the renal collecting system, i-MIMERsys helps surgeons maintain controlled fluid dynamics throughout RIRS procedures, supporting safer and more efficient stone management.