Taguchi Kazumi, Yang Heiko, Bayne David B, Unno Rei, Hamamoto Shuzo, Chi Thomas, Yasui Takahiro
Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Division of Urology, Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA.
Int J Urol. 2025 Jul;32(7):793-803. doi: 10.1111/iju.70057. Epub 2025 Apr 24.
In the dynamic field of urology, percutaneous nephrolithotomy is the gold standard procedure for treating large kidney stones and has greatly benefitted from technological advancements that improve its safety and efficacy. This review highlights significant innovations in percutaneous nephrolithotomy including integrated navigation systems, robotics, artificial intelligence, and suction access sheaths, each collectively providing greater precision and improved patient outcomes. Three-dimensional navigation systems offer unparalleled anatomical insights, facilitate more accurate targeting, and reduce intraoperative complications, as evidenced by studies demonstrating higher success rates and shorter operation times. Robotic advancements can further refine percutaneous nephrolithotomy by offering superior control and accuracy. Emerging technologies such as the automated needle targeting with X-ray and MONARCH platforms show the potential to reduce radiation exposure and improve procedural efficiency. Additionally, artificial intelligence in percutaneous nephrolithotomy is a novel tool for preoperative planning and outcome prediction, which can enhance decision-making and potentially lead to customized treatment strategies. Suction access sheaths represent another important innovation that facilitates stone removal and reduces the risk of postoperative complications. Integration of these technologies can improve how urologists perform percutaneous nephrolithotomy, and it highlights the benefit of ongoing research and development in the evolving field of kidney stone surgery. Through a comprehensive analysis of peer-reviewed studies, this manuscript delves into the advancements of the last 5 years, underscoring the transformative impact of these innovations on percutaneous nephrolithotomy and setting the stage for future developments in this critical field of urology.
在泌尿外科这一充满活力的领域，经皮肾镜取石术是治疗大肾结石的金标准手术，并且极大地受益于提高其安全性和有效性的技术进步。本综述重点介绍了经皮肾镜取石术的重大创新，包括集成导航系统、机器人技术、人工智能和吸引鞘，这些创新共同提高了手术的精准度并改善了患者预后。三维导航系统提供了无与伦比的解剖学见解，有助于更精确的定位，并减少术中并发症，研究表明其成功率更高且手术时间更短，证明了这一点。机器人技术的进步通过提供卓越的控制和精准度，可以进一步优化经皮肾镜取石术。诸如X射线自动针定位和MONARCH平台等新兴技术显示出减少辐射暴露和提高手术效率的潜力。此外，经皮肾镜取石术中的人工智能是术前规划和结果预测的新型工具，可增强决策制定并可能带来定制化治疗策略。吸引鞘是另一项重要创新，有助于结石清除并降低术后并发症风险。这些技术的整合可以改善泌尿外科医生进行经皮肾镜取石术的方式，并凸显了在不断发展的肾结石手术领域持续研发的益处。通过对同行评审研究的全面分析，本手稿深入探讨了过去5年的进展，强调了这些创新对经皮肾镜取石术的变革性影响，并为泌尿外科这一关键领域的未来发展奠定了基础。
