Level I/II autonomy in robotically navigated lithotripsy: comprehensive system evaluation and performance assessment.

IF 2 4区医学 Q2 SURGERY

Minimally Invasive Therapy & Allied Technologies Pub Date : 2025-10-03 DOI:10.1080/13645706.2025.2568611

Lambros Athanasiou, Manivannan Senthil Kumar, Franklin King, Daniel A Wollin, Nobuhiko Hata

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引用次数: 0

Abstract

Background: Laser lithotripsy is a minimally invasive procedure performed by a urologist using a ureteroscope, a device composed of a flexible laser fiber and a camera. The camera is used to physically view and manually target the stone ablated by the laser. The procedure involves the risk of unintentional trauma caused by the laser when the stones are out of target due to their retro-pulsive movement.

Methods: To minimize clinical complications, we propose a Level I/II autonomous system in robotic lithotripsy. The system consists of a robotic catheter and an integrated U-Net segmentation method. The system aims to automatically target the stones during lithotripsy and guide ureteroscope navigation autonomously.

Results: The proposed system is designed and validated using a phantom specifically manufactured to investigate the feasibility of autonomous stone ablation. An overall target accuracy of 99.97% (leave-one-out: 99.971 min, 99.975 max) was reported.

Conclusions: We successfully implemented a stone targeting method and integrated it with our robotic system to evaluate the level of success in autonomously targeting the stones. The results, indicate that autonomy in robot assisted lithotripsy is feasible.

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机器人导航碎石术中的I/II级自主性：综合系统评估和性能评估。

背景：激光碎石是泌尿科医生使用输尿管镜进行的微创手术，输尿管镜是一种由柔性激光纤维和相机组成的设备。摄像机用于物理观察和手动瞄准激光烧蚀的石头。这个过程涉及到激光造成的意外创伤的风险，当石头由于其反向脉冲运动而偏离目标时。方法：为了减少临床并发症，我们提出了一种I/II级自动机器人碎石系统。该系统由机器人导管和集成的U-Net分割方法组成。该系统旨在实现碎石过程中结石的自动定位，引导输尿管镜自主导航。结果：该系统的设计和验证使用了一个专门制造的模型来研究自主石头消融的可行性。总体目标准确度为99.97%（遗漏：99.971 min, 99.975 max）。结论：我们成功地实施了一种结石靶向方法，并将其与我们的机器人系统相结合，以评估自主靶向结石的成功程度。结果表明，自主机器人辅助碎石是可行的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Minimally Invasive Therapy & Allied Technologies 医学-外科

CiteScore

3.80

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.