Robot-Assisted Retrograde Intrarenal Surgery: A Mini Review of the Literature on Robotic Surgery Platforms for Endoscopic Stone Surgery.

Journal: European urology focus
Published Date: Jul 4, 2025

Abstract

Retrograde intrarenal surgery (RIRS) has become a cornerstone in renal stone management, with robotic platforms recently entering clinical practice. This mini review examines the current landscape for robot-assisted RIRS, with a focus on the Roboflex Avicenna, ILY, Monarch, and Zamenix systems. Early clinical data demonstrate feasibility and safety, with potential ergonomic advantages, although robust evidence supporting superiority over conventional techniques remains limited. We describe the distinctive features of each platform, including console design, scope control mechanisms, and integration with endourological tools, and their regulatory status and clinical implementation. Potential benefits include better scope navigation, lower radiation exposure, and enhanced stone clearance, while challenges include high costs, limited accessibility, and the absence of tactile feedback. Future developments may integrate artificial intelligence, real-time surgical guidance, and miniaturized systems. As this technology matures, robotic RIRS could redefine management paradigms for complex stone cases and other upper tract pathology for which conventional approaches prove challenging. PATIENT SUMMARY: We reviewed studies on robot-assisted surgery for kidney stones. Early evidence shows that this approach has greater precision, lower radiation exposure, and less fatigue for the surgeon. It is expected that robotic surgery will result in better outcomes for these patients, but more studies are needed to confirm the early findings.

Authors

  • Hyung Joon Kim
    Department of Urology, Konyang University, College of Medicine, Daejeon, Korea.
  • Jose Carlo R Elises
    Division of Urology, Department of Surgery, Philippine General Hospital, University of the Philippines, Manila, Philippines.
  • Christine Joy Castillo
    Department of Urology, Jose R. Reyes Memorial Medical Center, Manila, Philippines.
  • Nasser Aljameel
    Department of Urology, King Salman Hospital, Riyadh, Saudi Arabia.
  • Fahad Alzahrani
    Department of Urology, East Jeddah Hospital, Jeddah, Saudi Arabia.
  • Omar Sulaiman
    Department of Urology, King Fahad Hospital, Jeddah, Saudi Arabia.
  • Sung Yong Cho
    Department of Urology, College of Medicine, Seoul National University Hospital, Seoul National University, Gwanak-gu, Seoul, South Korea.

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