CoFlex TOP: A teleoperation system for flexible ureteroscopy*

In flexible ureteroscopy (fURS) for kidney stones, the renal collecting system is inspected and stones are removed with a flexible ureteroscope (FU).One alternative to the fragmentation of stones and their removal with the help of graspers or extraction baskets is the dusting of stones with laser light.To support a single surgeon during a fURS procedure, in particular with the fine manipulation during dusting, we developed the CoFlex TOP system for the teleoperation of a handheld FU with three degrees of freedom.This paper describes the overall structure of the system, its kinematics and the hardware and software components.Subsequently, the system properties and its position repeatability are investigated and the system's feasibility for a tip positioning task in virtual reality is evaluated in a user study.Finally, we discuss the implications of the evaluation and sketch possible foci of a user study with urology surgeons.