Ultrasonographic-guided robotic-assisted percutaneous nephrolithotomy.

Area of Science:

• Urology
• Medical Robotics
• Surgical Simulation

Background:

• Percutaneous nephrolithotomy (PCNL) is the standard treatment for large kidney stones (>20 mm).
• Accurate percutaneous access is critical but technically demanding, requiring significant surgeon expertise.
• Novice surgeons often face challenges in performing the initial puncture for PCNL.

Purpose of the Study:

• To introduce and validate a novel robotic system for PCNL.
• To enhance the accuracy and safety of percutaneous kidney access.
• To facilitate the training and performance of less experienced urologists in PCNL.

Main Methods:

• Development of a robotic system integrating 3D anatomical modeling and real-time ultrasound guidance.
• Validation in a clinical simulation environment.
• Performance evaluation by experienced urologists and urology residents.

Main Results:

• The robotic system demonstrated improved surgical performance in kidney access.
• The system contributed to a reduction in human error during the procedure.
• Both experienced and novice surgeons showed enhanced confidence and accuracy with the system.

Conclusions:

• The proposed robotic system effectively improves percutaneous nephrolithotomy access.
• This technology makes complex urological procedures more accessible to less experienced clinicians.
• Robotic assistance holds significant potential for enhancing surgical training and patient safety in PCNL.