The LARC Robot Simplifies Renal Access In Percutaneous Nephrolithotomy
NCT ID: NCT07211555
Last Updated: 2025-10-08
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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NOT_YET_RECRUITING
NA
45 participants
INTERVENTIONAL
2025-11-01
2026-01-01
Brief Summary
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Traditionally, many urologists rely on radiologists to place a tube into the kidney before surgery. This can cause delays, require multiple procedures, and increase costs. The robotic system being studied - called LARC - is designed to help the urologist safely and accurately guide a needle directly into the kidney during the surgery, without needing a separate procedure beforehand.
The robot uses live X-ray images to help align the instruments. Although parts of the robot have been approved by the U.S. FDA, the version used in this study is still investigational and not yet approved for this specific purpose.
The study will take place at AdventHealth Celebration and include up to 45 adult patients who are scheduled for PCNL surgery. Participants will be followed for up to 1 month after surgery, and doctors will look at outcomes such as the success of the procedure, the number of kidney stones removed, complications, time in surgery, and radiation exposure.
This research may help make kidney stone surgery safer, faster, and more effective in the future.
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Detailed Description
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Conditions
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Study Design
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NA
SINGLE_GROUP
TREATMENT
NONE
Study Groups
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Assisted PCNL Using LARC System
This arm includes participants who will undergo percutaneous nephrolithotomy (PCNL) with renal access guided by the investigational LARC robotic system (Version 3.0). The procedure uses fluoroscopy-based navigation to assist the urologist in targeting the renal collecting system.
LARC Robotic System (Micromate™ Version 3.0)
The LARC Robotic System (Version 3.0) is an investigational configuration of the Micromate™ robotic platform by iSYS Medizintechnik GmbH (Austria). It uses fluoroscopy-based surgical navigation to assist urologists in obtaining precise renal access during percutaneous nephrolithotomy (PCNL). This version is not FDA-cleared and is being evaluated for feasibility, safety, and potential clinical benefit.
Interventions
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LARC Robotic System (Micromate™ Version 3.0)
The LARC Robotic System (Version 3.0) is an investigational configuration of the Micromate™ robotic platform by iSYS Medizintechnik GmbH (Austria). It uses fluoroscopy-based surgical navigation to assist urologists in obtaining precise renal access during percutaneous nephrolithotomy (PCNL). This version is not FDA-cleared and is being evaluated for feasibility, safety, and potential clinical benefit.
Eligibility Criteria
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Inclusion Criteria
* Staghorn renal calculi
* Lower pole stones less than 2 cm
* Anatomical abnormalities that reduce the likelihood of spontaneous stone fragment passage, such as:
* Horseshoe kidney
* Calyceal diverticulum
* Ectopic or dystopic kidney
* Stones that are refractory to prior treatment (e.g., ESWL or ureteroscopy)
* Suspected malignant tumors or masses located in the planned renal access tract
Exclusion Criteria
* Active urinary tract infection (UTI) or untreated sepsis
* Known bleeding disorders or uncorrectable coagulopathy despite medical management
* Use of anticoagulant medications (e.g., warfarin, heparin, or DOACs) that cannot be safely discontinued
* Allergy to contrast media that cannot be pre-medicated or managed
* Severe cardiopulmonary comorbidities that contraindicate anesthesia or PCNL
* Inability to provide informed consent
* Participation in another investigational study that may interfere with study outcomes
18 Years
ALL
No
Sponsors
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AdventHealth
OTHER
Responsible Party
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Locations
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Advent Health Medical Group Urology at Celebration
Celebration, Florida, United States
Countries
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Central Contacts
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Petronio Senior Clinical Research Operations Manager, MHA
Role: CONTACT
Facility Contacts
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References
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Taylor E, Miller J, Chi T, Stoller ML. Complications associated with percutaneous nephrolithotomy. Transl Androl Urol. 2012 Dec;1(4):223-8. doi: 10.3978/j.issn.2223-4683.2012.12.01. No abstract available.
de la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R, Tefekli A; CROES PCNL Study Group. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: indications, complications, and outcomes in 5803 patients. J Endourol. 2011 Jan;25(1):11-7. doi: 10.1089/end.2010.0424.
Korets R, Speed JM, Wang Y, Chang SL. PD21-03 Percutaneous Access Obtained By Urologist Is Associated With Decreased Complications, Shorter Length Of Stay, And Lower Hospital Costs In PCNL. J Urol. 2017;197(4S):e436-e437. doi:10.1016/j.juro.2017.02.1041
Ghoulian J, Nourian A, Dalimov Z, Ghiraldi EM, Friedlander JI. Percutaneous Nephrolithotomy Access: A Meta-Analysis Comparing Access by Urologist vs Radiologist. J Endourol. 2023 Jan;37(1):8-14. doi: 10.1089/end.2022.0308. Epub 2022 Nov 14.
Armitage JN, Withington J, Fowler S, Finch WJG, Burgess NA, Irving SO, Glass J, Wiseman OJ; BAUS section of Endourology. Percutaneous nephrolithotomy access by urologist or interventional radiologist: practice and outcomes in the UK. BJU Int. 2017 Jun;119(6):913-918. doi: 10.1111/bju.13817. Epub 2017 Mar 21.
Speed JM, Wang Y, Leow JJ, Bhojani N, Trinh QD, Chang SL, Korets R. The Effect of Physician Specialty Obtaining Access for Percutaneous Nephrolithotomy on Perioperative Costs and Outcomes. J Endourol. 2017 Nov;31(11):1152-1156. doi: 10.1089/end.2017.0441. Epub 2017 Oct 4.
Quirke K, Aydin A, Brunckhorst O, Bultitude M, Khan MS, Dasgupta P, Sarica K, Ahmed K. Learning Curves in Urolithiasis Surgery: A Systematic Review. J Endourol. 2018 Nov;32(11):1008-1020. doi: 10.1089/end.2018.0425.
Metzler IS, Holt S, Harper JD. Surgical Trends in Nephrolithiasis: Increasing De Novo Renal Access by Urologists for Percutaneous Nephrolithotomy. J Endourol. 2021 Jun;35(6):769-774. doi: 10.1089/end.2020.0888. Epub 2021 Apr 5.
Escobar Monroy R, Proietti S, De Leonardis F, Gisone S, Scalia R, Mongelli L, Gaboardi F, Giusti G. Complications in Percutaneous Nephrolithotomy. Complications. 2025; 2(1):5. https://doi.org/10.3390/complications2010005
Nguyen MV, Berger JH, Flores AR, Chen TT, Yared J, Pais V, Chew B, Humphreys MR, Stern KL, Sur RL. Case series - Liver injury during percutaneous nephrolithotomy. Can Urol Assoc J. 2023 Sep;17(9):E297-E301. doi: 10.5489/cuaj.8291. No abstract available.
Saluk J, Ebel J, Rose J, Posid T, Sourial M, Knudsen B. Fellowship training in endourology: Impact on percutaneous nephrolithotomy access patterns. Can Urol Assoc J. 2022 Feb;16(2):E76-E81. doi: 10.5489/cuaj.7339.
Other Identifiers
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2196760
Identifier Type: -
Identifier Source: org_study_id
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