Renal calculi represent a common urological condition, with retrograde intrarenal surgery (RIRS) emerging as the primary treatment modality due to its minimally invasive nature and high efficacy. Elevated intrarenal pressure during RIRS frequently leads to complications such as infection and renal tissue injury, which significantly compromise surgical safety. The suction ureteral access sheath (SUAS), an innovative device, effectively controls intrarenal pressure through active suction, thereby improving surgical visualization and enhancing lithotripsy efficiency. The SUAS has shown to be very useful in clinical practice, and it has become an important tool for making kidney stone surgery safer and more effective. This paper aims to systematically explore the application value of the SUAS to control intrarenal pressure and perform kidney stone surgery, providing theoretical support for clinical practice. The results of related studies have indicated that the SUAS can effectively reduce the peak intrarenal pressure, improve the surgical field, and increase the efficiency of lithotripsy through the mechanism of “perfusion-absorption balance”, thus significantly reducing the postoperative fever, urogenital septicemia, and reoperation rate, especially in complex stones and high-risk groups. In this paper, it can be concluded that the SUAS is a key tool for controlling intrarenal pressure in RIRS, which can significantly improve the safety and effectiveness of surgery and has a broad clinical application prospect.
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