Robotic Flexible Ureteroscopy: A Step-by-step Video by Using Roboflex Avicenna TM Platform.

BACKGROUND: The management of kidney stones, particularly those in the renal pelvis, is a critical aspect of urology. The European Association of Urology guidelines recommend Extracorporeal Shock Wave Lithotripsy or Endourology methods, encompassing Percutaneous Nephrolithotomy and Ureterorenoscopy (URS), for stones ranging from 10-20 mm. Robotic-assisted urological procedures have gained prominence in recent years, promising enhanced precision, and safety.

OBJECTIVES: This article aims to provide a detailed account of the technical aspects and outcomes of a robotic URS (robo-URS) procedure in a 63-year-old male patient with a 15 mm renal pelvis stone, serving as a reference for urologists considering this approach.

MATERIALS: The patient presented with right flank pain, and an unenhanced computed tomography scan confirmed the presence of a 15x12x13 mm stone in the right renal pelvis. After assessment and preparation, robo-URS was performed using the Roboflex Avicenna robotic platform (ELMED, Ankara, Turkey) in conjunction with conventional urological instruments and laser technology.

RESULTS: The procedure was completed successfully in 50 minutes without any detectable blood loss or intraoperative complications.

CONCLUSION: Robotic-assisted Ureterorenoscopy (robo-URS) is a promising approach for managing renal pelvis stones. The procedure, demonstrated in this video article, underscores its technical feasibility, safety, and efficacy, making it a valuable resource for urologists seeking to expand their knowledge in stone management techniques.