Evaluation of a New Robotic System for Flexible Ureterolithotripsy in Animal Model - Experimental Study

• Grant number: 24/13449-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: October 01, 2024
• End date: September 30, 2025
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Carlos Alfredo Batagello
• Grantee: José Vinicius da Silva Campêlo
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Urinary lithiasis is a disease with worldwide distribution, with a prevalence varying between 1 and 13% , depending on the region of the world analyzed. Its treatment has evolved significantly over the last 30 years, so that, currently, its main forms of treatment are represented by extracorporeal lithotripsy (ESL), ureteroscopy (semi-rigid and flexible) and percutaneous nephrolithotripsy (PCNL).Flexible ureteroscopy (FURS) has become one of the main methods for treating kidney stones. However, it can be a challenging and time-consuming procedure, resulting in greater risks to the patient and wear and tear on the surgeon. Therefore, issues related to patients (success and safety) and surgeons (efficiency and ergonomics) must be considered. FURS's ergonomics definitely impact the surgical result and preservation of the ureteroscope. Prolonged and complex procedures result in fatigue, reduction in the surgeon's performance and reduction in the useful life of the devices. Most urologists perform FURS in a standing position, assuming a suboptimal posture that can result in orthopedic problems.As part of this technological evolution, robotic surgery has definitely influenced minimally invasive surgery in the last 20 years, optimizing patient treatment and improving surgeons' working conditions. On the console, the comfortably seated surgeon has access to a digital, three-dimensional and magnified image of the surgical field. Joy-sticks are used in the hands that control robotic arms and tweezers with precision and a large range of movements, with the advantage of filtering fatigue and tremors from the surgeon's hands, allowing precise and delicate movements.In Brazil, SENAI CIMATEC, in partnership with the company RUSSER, developed the first Brazilian robot for flexible ureteroscopy, the object of evaluation in this study. The scientific contribution of the study to the scientific community will be to certify the usefulness of this new equipment in the daily life of urologists involved in the treatment of kidney stones. The main objective is to evaluate the ergonomics of the new robotic system for flexible ureteroscopy, as well as to evaluate surgical time (start of navigation until stone removal), navigability, robot malfunction / conversion to conventional URS and patient safety.