Around 5-9% of the population in Europe suffers from kidney stones in the course of their lives. The solid accumulations of minerals, salts and organic material can be treated in different ways. This depends on the size, location and composition of the stones as well as the patient’s kidney anatomy. In 30-40% of cases, larger kidney stones that block the urinary tract are treated by performing a ureteroscopy.

During flexible uretereoscopy, the renal collecting system is inspected and the stones are removed using a flexible ureteroscope. The stones are crushed beforehand and extracted using grippers and an extraction basket. Another method is to pulverize the stones using a laser. The use of a newly developed laser could make this method more important, as it enables a higher stone removal rate, which in turn leads to shorter treatment times for the patient. However, this procedure also poses some challenges. Two surgeons are always required to operate the ureteroscope, the laser and the extraction basket. This is often a problem due to the ongoing shortage of doctors and surgeons. This places a considerable burden on the healthcare system and results in longer waiting times and a reduced quality of care. As both surgeons have to interact with the same ureteroscope, an unergonomic posture is often inevitable. Handling is also not user-friendly: large wrist movements and the weight of the ureteroscope place a strain on the user.

Scientists at the German Aerospace Center have therefore developed a system that is able to support a single surgeon during a flexible ureteroscopy. The CoFlex TOP System makes it possible to switch between different surgical modes during the operation depending on the task at hand: manual surgery, solo surgery and teleoperation. This method would save both personnel and costs, avoid communication errors and expand the surgeon’s scope of action. It also enables a quick and tool-free transition between the three support degrees.

The paper was published on March 27, 2024 in the well-known journal IEEE Robotics and Automation Letters (DOI: 10.1109/LRA.2024.3382492).

The publication can be found online here.