ArticleWorld journal of urology2026
Simulation-based dosimetric analysis of surgeon radiation exposure during robotic-assisted versus conventional URS.
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. Not yet cited in PubMed.
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Abstract
objectiveFluoroscopy during urinary stone surgery exposes patients and operating staff to ionizing radiation. This study aims to model and estimate surgeon radiation dose in robotic-assisted versus conventional ureteroscopy (URS) using an experimental simulation to evaluate the potential safety advantages of robotic systems.
methodsA simulation-based dosimetric model was developed using retrospective fluoroscopy data from 35 clinical cases. Fluoroscopy time was divided into robotic-assisted and non-robotic-assisted phases. Radiation exposure was estimated using a three-stage simulation model at four positions: the patient plane near the X-ray tube (A), and three surgeon positions including 50 cm unshielded (B), 50 cm with lead protection (C), and 150 cm behind a mobile lead barrier (D). Exposure was calculated across five scenarios: Scenario 1 (Patient Mode [Reference Measurement], position A), Scenario 2 (Conventional Unprotected Mode, position B), Scenario 3 (Conventional Protected Mode, position C), Scenario 4 (Robotic-Assisted Partial Protection Mode; B non-robotic-assisted, D robotic-assisted), and Scenario 5 (Robotic-Assisted Full Protection Mode; C non-robotic-assisted, D robotic-assisted). Data were analyzed using t-test, Mann-Whitney U, and chi-square tests, and presented as median (IQR) or n (%).
resultsAmong 35 patients (mean age 46.6 ± 15.0 years) whose clinical data were utilized for the model, the mean total fluoroscopy time was 18.6 ± 10.1 s (5.2 ± 3.4 s robotic-assisted phase). The simulated radiation exposure differed significantly across scenarios (p < 0.05), with median estimated doses of 160,101.80, 56.93, 9.07, 40.88, and 6.97 µSv for Scenarios 1-5, respectively.
conclusionUnder simulated conditions, robotic-assisted URS significantly reduces surgeon radiation exposure. Specifically, the combination of increased distance and shielding minimizes these estimated dose levels.
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