Evidence map›Paper›PMID 42098473›Full record

ArticleWorld journal of urology2026

Quantifying ergonomic challenges for urologists operating flexible ureteroscopes through artificial intelligence-based posture estimation.

Satoshi Kobayashi, Keiji Tsukino, Mikifumi Koura, Tokiyoshi Tanegashi, Shigehiro Tsukahara, Takashi Matsumoto, Masaki Shiota, Masatoshi Eto

Abstract read
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Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Satoshi KobayashiDepartment of Urology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. kobayashi.satoshi.282@m.kyushu-u.ac.jp.ORCID http://orcid.org/0000-0002-7760-0771
Keiji TsukinoDepartment of Urology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.ORCID http://orcid.org/0009-0002-2955-6849
Mikifumi KouraDepartment of Urology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Tokiyoshi TanegashiDepartment of Urology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.ORCID http://orcid.org/0000-0002-1631-4720
Shigehiro TsukaharaDepartment of Urology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Takashi MatsumotoDepartment of Urology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Masaki ShiotaDepartment of Urology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.ORCID http://orcid.org/0000-0002-3306-4858
Masatoshi EtoDepartment of Urology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.ORCID http://orcid.org/0000-0001-9765-8842

Funding

Japanese Foundation for Research and Promotion of Endoscopy 2025Japanese Society of Endourology and Robotics Robot-assisted Surgery Research Grant AJapan Society for the Promotion of Science JP23K19219
6 · The paper itself

Abstract

purposeThe ergonomic challenges faced by surgeons during flexible ureteroscopy have yet to be thoroughly evaluated using objective methods. However, robot-assisted ureteroscopy has emerged as a promising treatment for urinary stones. The present study quantitatively assesses operative posture during transurethral ureteroscopy via an artificial intelligence-based posture estimation framework, and identifies kinematic differences associated with surgical expertise.

methodsExpert and novice urologists performed standardized flexible ureteroscopic tasks in a simulated transurethral ureteroscopy environment using kidney phantoms containing artificial stones. Upper-body movements were continuously video-recorded and joint coordinates of the shoulders, elbows, and wrists were extracted using an artificial intelligence-based pose estimation system. Kinematic parameters were quantitatively analyzed and compared between groups.

resultsExperts completed observation of the entire renal pelvis significantly faster than novices (median 58 vs. 102 s, p < 0.001). Accumulated travel distance was markedly less in experts for the left shoulder (125 vs. 300 cm, p < 0.001), right elbow (324 vs. 1035 cm, p = 0.028), left elbow (349 vs. 772 cm, p = 0.019), and left wrist (729 vs. 3798 cm, p < 0.001). Experts had smaller movement areas at the left shoulder (6.29 vs. 40.5 cm

conclusionsThe artificial intelligence-based posture analysis objectively demonstrated ergonomic advantages associated with surgical expertise during flexible ureteroscopy and revealed persistent ergonomic risks to the wrist and elbow.

Indexed as

Artificial IntelligenceErgonomicsPostureUreteroscopesUreteroscopyBiomechanical PhenomenaHumansArtificial intelligenceUreteroscopesUrinary calculiUrinary tract

Identifiers

PMID42098473

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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.