This involves use of lasers via small telescopes which are used to fragment stones. This can be done either with a rigid telescope or a flexible telescope.
Rigid ureteroscopy (URS) & stone fragmentation
Stones in the ureter can be removed or fragmented (broken up) using a laser by rigid ureteroscopy. The advantages of this include the fact that all stones, however hard, succumb to laser energy. However, the disadvantages include the need for hospital admission and a general anaesthetic. Despite being “minimally invasive” (i.e. it uses a natural opening & does not require an incision), it carries certain risks, and often involves having a ureteric stent for a short time afterwards; the stent will need a further procedure to remove it, usually under local anaesthetic.
https://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Ureteroscopy%20for%20stone.pdf
Flexible uretero-renoscopy (fURS) & stone fragmentation
Smaller stones in the kidney can be treated directly using a thin flexible telescope passed from your bladder to your kidney. We use a laser to break up the stone(s) and a basket retrieval device to remove the fragments. fURS is a complex surgical procedure which you should discuss with your urologist before you choose to go ahead. Again, it is likely that you will need a temporary stent after the procedure; if you need a second-phase operation (e.g. for one of the larger stone fragments), you may need to keep the stent in for several weeks between procedures; it can only be safely removed when all the stones have been cleared.
http://www.pchurology.co.uk/baus_cons/ureteroscopy%20and%20stone%20removal.pdf
