Investig Clin Urol.  2022 Nov;63(6):647-655. 10.4111/icu.20220237.

The usefulness and ergonomics of a new robotic system for flexible ureteroscopy and laser lithotripsy for treating renal stones

• Park J
• Gwak CH
• Kim D
• Shin JH
• Lim B
• Kim J
• Cheon B
• Han J
• Kwon DS
• Park HK

• KMID: 2534620
• DOI: http://doi.org/10.4111/icu.20220237

Abstract

Purpose
To investigate the usefulness and ergonomics of a newly developed robotic system for flexible ureteroscopy (easyUretero).
Materials and Methods
During in vitro testing, six participants performed renal stone removal four times in an artificial kidneyureter-bladder model. Each participant manipulated a single-use digital flexible ureteroscope (LithoVue) with their hands and the robotic system, sequentially. We compared the task completion times of each participant. The ergonomics of and operational satisfaction with each procedure were assessed by questionnaires. In vivo tests evaluated the operability and safety of the robotic system in two live female pigs. We checked that all the steps of flexible lithotomy for renal stones could be completed individually.
Results
The task completion time with the robotic system during in vitro testing was significantly longer than with manual ureteroscopy regardless of the operator’s competence level (expert professors: 282.6±92.4 seconds vs. 73.6±43.3 seconds, p<0.001; fellows: 247.5±57.7 seconds vs. 95.8±43.7 seconds, p<0.001; residents: 281.3±111.0 seconds vs. 188.6±138.6 seconds, p<0.001). The residents took more time to remove the upper and mid caliceal stones with the robotic system. The ergonomic evaluation was better for the robotic system, but operational satisfaction was lower, and there was no statistical difference among the groups. In vivo tests showed that all the steps of robotic flexible ureteroscopy could be completed without difficulty. No safety issues were encountered during the procedure.
Conclusions
The robotic system (easyUretero) was ergonomic and safe for flexible ureteroscopy and laser lithotripsy for renal stones.

Keyword

Robotics; Ureteroscopy; Urolithiasis