Evidence map›Paper›PMID 40484898›Full record

SynthesisWorld journal of urology2025

Surgical outcomes of robotic surgery for kidney stones: a systematic review and meta-analysis from section of YAU and EAU endourology.

Rifat Burak Ergül, M Fırat Özervarli, Frederic Panthier, Carlotta Nedbal, Arman Tsaturyan, Amelia Pietropaolo, Giovanni Cacciamani, Peter Kronenberg, Pieter De Backer, Chady Ghnatios and 6 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Article
  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Rifat Burak ErgülDepartment of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
M Fırat ÖzervarliDepartment of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Frederic PanthierDepartment of Urology, Tenon Hospital, AP-HP, Paris, France.
Carlotta NedbalDepartment of Urology, ASST Fatebenefratelli Sacco, Milan, Italy.
Arman TsaturyanDepartment of Urology, Erebuni Medical Center, Yerevan, Armenia.
Amelia PietropaoloDepartment of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Giovanni CacciamaniDepartment of Urology, Keck School of Medicine, USC Institute of Urology and Catherine & Joseph Aresty, University of Southern California, Los Angeles, CA, USA.
Peter KronenbergDepartment of Urology, Hospital CUF Descobertas, Lisbon, Portugal.
Pieter De BackerDepartment of Urology, ERN eUROGEN Accredited Centre, Ghent University Hospital, Ghent, Belgium.
Chady GhnatiosDepartment of Mechanical Engineering, University of North Florida, Jacksonville, FL, USA.
Zine-Eddine KheneUniversity of Texas Southwestern Medical Center, Dallas, TX, USA.
Sung Yong ChoDepartment of Urology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, 03080, Republic of Korea.
Ben TurneyDepartment of Urology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Bhaskar SomaniDepartment of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Olivier TraxerDepartment of Urology, Tenon Hospital, AP-HP, Paris, France.
Tzevat TefikDepartment of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. tztefik@istanbul.edu.tr.ORCID http://orcid.org/0000-0002-1398-8332

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUrinary tract stone disease is quite common in the population, and treatment modalities are constantly evolving. Technological advancements in endourology have led to a shift towards more minimally invasive treatments. Nowadays, robotic flexible ureteroscopy is becoming increasingly popular, showing promising results. This systematic review and meta-analysis aimed to evaluate the outcomes of robotic flexible ureteroscopy. MATERIALS AND

methodsWe conducted a systematic review in the PubMed, Scopus and Web of Science databases based on the 2020 Preferred Reporting Items for Systematic Review and Meta-Analyses guideline. Study protocol was registered at PROSPERO (CRD420251017383). All robotic flexible studies published until April 2025, which defined and provided the stone-free rate, were included. To assess surgical efficacy and reliability, stone size, operation time, and complications were also evaluated. Stone size was measured in a one-dimensional manner, based on the maximum length.

resultsA total of 320 studies were initially identified, with 11 full-text articles meeting the inclusion criteria, involving 656 patients and 660 renal units. The analysis included data from various robotic systems, including the Roboflex Avicenna, ILY, Senhance, and MONARCH platforms. The mean pooled stone-free rate was 86.0%, with a range from 57.7 to 96.5%, indicating variability across studies. The use of a random-effects model was justified by the presence of moderate-to-substantial heterogeneity across studies (I² = 63.5%, τ² = 0.627), and a statistically significant Q-test (p = 0.0022). The studies defined stone-free status as either complete stone clearance or residual fragments smaller than 2 mm.

conclusionThe analysis suggests that robotic URS is an effective and feasible treatment option for selected patients with urinary stones. Future research should focus on standardized reporting, comparative effectiveness studies, and cost-benefit analyses, while also addressing surgeon-centered outcomes such as ergonomic strain and musculoskeletal pain, to better define the role of robotic technology in endourological practice.

Indexed as

Kidney CalculiRobotic Surgical ProceduresUreteroscopyHumansTreatment OutcomeRetrograde intrarenal surgeryRobotic endourologyUreterorenoscopyUrolithiasis

Identifiers

PMID40484898
PMCPMC12146223

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.