Robotic Flexible Ureterorenoscopy with AI-Based Real-Time Stone Segmentation

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Ergül R. B., Aydınoğlu A. T., Erden M. E., Doğan P., Gharehmohammadlou A., Tefık T.

Urolithiasis Days 2026, Mersin, Türkiye, 8 - 09 Mayıs 2026, ss.17-20, (Tam Metin Bildiri)

  • Yayın Türü: Bildiri / Tam Metin Bildiri
  • Basıldığı Şehir: Mersin
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.17-20
  • İstanbul Üniversitesi Adresli: Evet

Özet

Introduction and Aim: Robotic flexible uretroscopy (robo-URS) is increasingly adopted in the management of renal stones; however, it involves a learning curve, particularly for less experienced surgeons. Real-time stone segmentation integrated into robotic systems may enhance intraoperative guidance. This study aimed to evaluate the feasibility, safety, and clinical performance of robot-integrated real-time stone segmentation during robo-URS. 

Material and Method: This retrospective, single-center pilot study included 15 patients who underwent robo-URS. Procedures were performed under general anesthesia by a first-year resident under supervision using the Roboflex Avicenna platform with FANS and a robot-integrated real-time segmentation module (Figure 1); thulium fiber laser lithotripsy was used. Demographic, clinical, perioperative, and ergonomic variables were recorded, including age, sex, BMI, stone characteristics, operative parameters, complications, stone-free status, and surgeon-reported ergonomic outcomes. 

Findings: Fifteen patients (mean age 48.9 ± 11.3 years; mean stone size 11.4 ± 4.2 mm) were included. Proximal ureter was the most common stone location (33.3%). Mean operative time was 88.3 ± 25.5 minutes, with docking and console times of 11.3 ± 3.8 and 45.8 ± 24.3 minutes, respectively. Laser fragmentation time was 27.0 ± 15.4 minutes. Stone-free rate was 86.7% based on postoperative day 1 CT. Biochemical parameters remained stable, and mean hospital stay was 1.3 ± 1.6 days. Minor intraoperative complications occurred in two patients (13.3%) as mucosal bleeding. Two patients (13.3%) developed Clavien–Dindo grade II complications due to UTI requiring antibiotic therapy. (Table 1) Robo-URS demonstrated favorable ergonomic outcomes, with minimal musculoskeletal strain, suggesting a potential role in reducing surgeon fatigue and improving long-term operator sustainability. (Table 2)