Cold weather often leads to reduced fluid intake, which can result in more concentrated urine and a steady increase in urinary stone cases. Urinary stones can form anywhere along the urinary tract—from the kidneys to the ureters, bladder, and urethra—and may cause severe flank pain, hematuria, vomiting, or fever. The intensity of symptoms varies depending on the size and location of the stone, and in some cases, stones are discovered incidentally during routine check-ups without any symptoms. When stones are small (typically less than 4 mm), increased hydration may allow for spontaneous passage. However, larger stones or those causing obstruction require active treatment.
The most commonly performed treatment is extracorporeal shock wave lithotripsy (ESWL). This non-invasive procedure can be performed on an outpatient basis and allows for quick recovery. However, depending on the stone’s composition and location, multiple sessions may be required.
For more definitive removal, ureteroscopic stone surgery is often performed. This procedure involves inserting an endoscope through the urethra to directly visualize the stone and fragment it using a laser. While it has a high success rate, larger stones or poor visibility can prolong operative time, and the procedure requires precise manual control, which can lead to surgeon fatigue.
To address these limitations, an AI-based robotic system for stone surgery, known as Zamenix, has recently been introduced and is gaining attention. Zamenix is a robot-assisted platform that allows the surgeon to control the endoscope and surgical instruments from a console using a precision control interface. This system reduces hand tremor and enables stable navigation within the narrow anatomy of the ureter, achieving a stone clearance rate of approximately 93.5%.
In conventional procedures, assistants are often required to manually operate stone retrieval devices in coordination with the surgeon. With Zamenix, the surgeon can directly control these functions from the console, improving precision and efficiency during surgery.
The key feature of Zamenix lies in its AI capabilities. First, the system includes an automatic path memory function that records the route once accessed and allows the surgeon to re-enter the same location accurately with a single command. Second, a respiratory compensation algorithm adjusts the position of the endoscope in real time according to the patient’s subtle breathing movements, enabling stable laser targeting without unintended motion. Third, the system incorporates stone size recognition, which analyzes in real time whether fragments can safely pass through the access sheath, thereby reducing excessive manipulation and lowering the risk of complications.
These technological advancements go beyond improving surgeon convenience—they directly contribute to patient safety and surgical outcomes. Clinical benefits include reduced operative time, lower risks of bleeding and infection, and improved stone clearance rates. In this sense, robotic assistance helps overcome the physical limitations of conventional endoscopic surgery.
However, robotic surgery is not necessary for all patients. The choice of treatment should be based on a comprehensive evaluation of stone size, location, presence of infection, and individual anatomy. Options include ESWL, ureteroscopy, percutaneous procedures, and robot-assisted surgery. In cases of recurrent, large, or complex stones, AI-assisted robotic surgery may offer a valuable alternative.
The treatment of urinary stones continues to evolve rapidly with advances in technology. AI-based robotic systems such as Zamenix enhance the surgeon’s capabilities and provide a safer and more precise treatment environment for patients. As AI technology continues to develop, further improvements in both the safety and effectiveness of stone treatment are expected.