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Journals / Endoüroloji Bülteni / 2026 / Cilt: 18 Sayı: 3

Comparative Analysis of Avicenna Roboflex® and Conventional Ureteroscopy: A Porcine Model Study of Safety and Feasibility in Stone Management

Avicenna Roboflex® Ile Konvansiyonel Üreteroskopinin Karşılaştırılması: Taş Tedavisinde Güvenlik Ve Uygulanabilirliğin Domuz Modelinde Deneysel Analizi

Rifat Burak Ergül(Mus State Hospital)0000-0001-6262-9582
Feyzi Arda Atar(ACIBADEM UNIVERSITY)0000-0001-7831-1501
Ahmet Sinan Kabakci(Department of Bioengineering, Hacettepe University, Ankara, Türkiye)0009-0007-2854-9010
Zafer Tokatlı(Private Cankaya Yasam Hospital)0000-0001-8019-827X
Ahmet Barış Aydın(Eyüpsultan State Hospital)0000-0001-9592-6057
Pelin Çelikbilek Erkasap(ACIBADEM UNIVERSITY)0009-0005-4153-2198
Seçkin Serdar Arun(Istanbul University, Faculty of Veterinary Medicine)0000-0002-0560-2065
Mustafa Sofikerim(ACIBADEM UNIVERSITY)0000-0001-8547-8537
Tzevat Tefik(ISTANBUL UNIVERSITY, İSTANBUL FACULTY OF MEDICINE, İSTANBUL MEDICINE PR.)0000-0002-1398-8332
Pages
212–220
Publication Date
2026-09-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Given the exploratory nature and small sample size of the study, these findings should be considered preliminary and require validation in adequately powered studies.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: Robotic-assisted ureteroscopy is increasingly adopted in endourology.
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Key Findings & Data:Materials and Methods: The Avicenna Roboflex® platform was compared with conventional ureteroscopy in a live porcine model (n = 6) in the supine lithotomy position.
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Conclusion & Impact:Given the exploratory nature and small sample size of the study, these findings should be considered preliminary and require validation in adequately powered studies.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:böbrek taşları · robotik cerrahi prosedürler · üreteroskopi

Abstract

Objective: Robotic-assisted ureteroscopy is increasingly adopted in endourology. We aimed to evaluate the feasibility and safety of the Avicenna Roboflex® Urology system (Elmed, Ankara, Turkey) compared with conventional ureteroscopy in a porcine model. Materials and Methods: The Avicenna Roboflex® platform was compared with conventional ureteroscopy in a live porcine model (n = 6) in the supine lithotomy position. Two experienced endourologists assessed task performance using Likert scales (1–4) for accuracy/workaround and ease of completion. Intraoperative events and ureteral injury were evaluated using the post-ureteroscopic lesion scale (PULS, 0–5). Histopathological assessment of tissue samples was performed by a blinded pathologist. Paired comparisons were performed using the 2-sided Wilcoxon signed-rank test, with p < 0.05 considered statistically significant. Results: A total of 12 ureteroscopic procedures (6 conventional, 6 robotic) were completed without intraoperative complications. Histopathological analysis revealed no significant differences between groups, with minimal epithelial loss observed only in the proximal ureter. Task performance scores were comparable between groups; however, the robotic system showed a trend toward improved ease in flexible ureteroscope insertion and simulated stone removal. PULS scores were low and similar in both groups. Conclusion: The Avicenna Roboflex® system demonstrated procedural feasibility and an acute tissue safety profile comparable to conventional ureteroscopy in this porcine model. Given the exploratory nature and small sample size of the study, these findings should be considered preliminary and require validation in adequately powered studies.

Özet

Amaç: Robotik destekli üreteroskopi endoürolojide giderek daha fazla kullanılmaktadır. Bu çalışmada, Avicenna Roboflex® Üroloji sisteminin (Elmed, Ankara, Türkiye) uygulanabilirliği ve güvenliği, konvansiyonel üreteroskopi ile domuz modelinde karşılaştırıldı. Gereç ve Yöntemler: Avicenna Roboflex® platformu, canlı domuz modelinde (n = 6) supin litotomi pozisyonunda konvansiyonel üreteroskopi ile karşılaştırıldı. İki deneyimli endoürolog, işlemlerin başarıyla tamamlanmasını doğruluk/alternatif çözüm ve görev tamamlama kolaylığı açısından Likert ölçeği (1–4) ile değerlendirdi. İntraoperatif olaylar ve üreter hasarı, post-üreteroskopik lezyon skoru (PULS, 0–5) ile değerlendirildi. Doku örnekleri kör bir patolog tarafından histopatolojik olarak incelendi. Eşleştirilmiş karşılaştırmalarda iki yönlü Wilcoxon işaretli sıralar testi kullanıldı ve p < 0.05 anlamlı kabul edildi. Bulgular: Toplam 12 üreteroskopi işlemi (6 konvansiyonel, 6 robotik) komplikasyonsuz olarak tamamlandı. Histopatolojik değerlendirmede gruplar arasında anlamlı fark saptanmadı; epitel kaybı yalnızca proksimal üreterde minimal düzeyde gözlendi. Görev performans skorları benzerdi; ancak robotik sistem, fleksibl üreteroskopun yerleştirilmesi ve taş çıkarımını simüle eden işlemlerde daha iyi görev tamamlama kolaylığı eğilimi gösterdi. PULS skorları her iki grupta da düşük ve benzerdi. Sonuçlar: Avicenna Roboflex® sistemi, bu domuz modelinde konvansiyonel üreteroskopi ile karşılaştırıldığında benzer prosedürel uygulanabilirlik ve akut doku güvenliği profili göstermiştir. Çalışmanın keşifsel niteliği ve küçük örneklem büyüklüğü göz önüne alındığında, bu bulgular öncül nitelikte değerlendirilmeli ve yeterli güce sahip ileri çalışmalarla doğrulanmalıdır.

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Cite This Article

Ergül, R. B., Atar, F. A., Kabakci, A. S., Tokatlı, Z., Aydın, A. B., Erkasap, P. Ç., Arun, S. S., Sofikerim, M., Tefik, T. (2026). Comparative Analysis of Avicenna Roboflex® and Conventional Ureteroscopy: A Porcine Model Study of Safety and Feasibility in Stone Management. Endoüroloji Bülteni, Cilt: 18 Sayı: 3, 212–220. https://doi.org/10.54233/endourolbull-1937415

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