Robotics in Endourological Interventions: Improving Ergonomics and Outcomes

What is it about?

In recent years, technological advancements have led to the development of robot-assisted surgery, which offers potential benefits in terms of ergonomics and patient outcomes. Robot-assisted retrograde intrarenal surgery (roboRIRS) has emerged as a promising approach to improve the operative outcomes, ergonomic conditions, and impact on surgeon health of conventional flexible ureteroscopy (fURS). The ILY robotic system is a compact trolley mini-console operated remotely by a wireless controller, which keeps the surgeon away from sources of ionising radiation. This letter describes a case series of six patients who underwent roboRIRS for urolithiasis at a center in July 2023. All procedures were performed by experienced endourologists, and the patients had stable renal function and no intraoperative complications or device-related failures. The surgeon's satisfaction with the robot was evaluated through a four-item questionnaire based on a Likert-type scale, and the overall score was 4/5. This letter presents the first clinical experience of roboRIRS with the ILY robotic system performed in human patients, and the use of this robotic device appears feasible and safe.

Featured Image

Why is it important?

This research is important for several reasons. Firstly, it addresses the issue of ergonomic deficiencies in flexible ureteroscopy (fURS), which can cause musculoskeletal disorders and impair the capacity and quality of work performance. Secondly, it explores the potential benefits of implementing robotics in endourological interventions, such as improving ergonomics and reducing radiation exposure and operation time. Thirdly, it presents the first clinical experience with the ILY robotic system for retrograde intrarenal surgery (roboRIRS), demonstrating its feasibility and safety. Finally, it contributes to the existing literature on this topic and paves the way for further research and investigations into the use of robotic technology in urologic surgery. Key Takeaways: 1. Ergonomic deficiencies in fURS can cause musculoskeletal disorders and impair the capacity and quality of work performance. 2. Robot-assisted retrograde intrarenal surgery (roboRIRS) has the potential to improve ergonomics and reduce radiation exposure and operation time in endourological interventions. 3. The ILY robotic system is a novel robotic platform that is compatible with all types of flexible ureteroscopes and most ureteric access sheaths, and it has a wireless controller to remotely manipulate the flexible ureteroscope. 4. The use of the ILY robotic system for roboRIRS is feasible and safe, but further investigations are needed to evaluate its benefit in real-life scenarios and cost-effectiveness.