Towards a Percutaneous Nephrolithotomy Ultrasound-guided Robotic System for Renal Access

Obtaining renal access in percutaneous nephrolithotomy (PCNL) is a crucial yet challenging step, characterized by a steep learning curve. While fluoroscopy is the conventional imaging tool for obtaining renal access, ultrasonography offers distinct advantages, including reduced radiation exposure and real-time imaging capabilities. This paper underscores the unique difficulties associated with renal access in comparison to other percutaneous procedures and proposes the implementation of an ultrasound-guided robotic system to provide accurate and effective access. The study delves into the design and development of this innovative system and presents an initial assessment based on tests conducted on a kidney phantom.Clinical relevance—The application of a robotic system guided by ultrasound in PCNL offers increased confidence to both surgeons and patients due to its low-risk approach in terms of radiation exposure. Additionally, this system helps minimize hemorrhagic complications during renal access, enhancing the overall safety of the surgical procedure.