# A Navigational System for Endoscopic Kidney Stone Surgery

> **NIH NIH R21** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2024 · $190,649

## Abstract

PROJECT SUMMARY/ABSTRACT
The importance of achieving stone-free status during endoscopic kidney stone surgery is emphasized by the
high rate of repeat stone procedures due to residual fragments after index surgery. Specifically, residual stone
fragments can lead to obstruction, pain, kidney injury, and recurrent infections. Successful endoscopic stone
surgery requires the surgeon to visualize the entire renal collecting system and locate all kidney stones during
treatment. Several challenges can lead to incomplete stone treatment and include inadequate stone visibility and
difficulty navigating through the kidney. Specifically, blood or debris can frequently obscure the already limited
field of view during endoscopic stone surgery. Additionally, successfully navigating through the collecting system
requires the surgeon to mentally create a 3D model of the patient’s anatomy from preoperative 2D axial
computerized tomography (CT) images. During treatment, moreover, stones can fragment and disperse
throughout the collecting system, further complicating intraoperative tracking. Though technical constraints of
scopes may also impact surgical kidney stone outcomes, the above limitations of endoscopic stone treatment
prevent many surgeons from achieving a complete stone-free status.
Our overall goal is to create a navigational system that makes stone localization and tracking within the renal
collecting system easier and more accurate for the surgeon. Toward this goal, our specific objective in this
proposal is to test the hypothesis that a navigational system during endoscopic stone surgery can improve stone-
free rates, mitigating recurrent surgeries or complications from residual fragments. To test this hypothesis, we
propose two Specific Aims: Aim 1 involves the development of an automatic, real-time segmentation and tracking
system of kidney stones during endoscopic stone surgery. Aim 2 integrates a 3D navigational map of collecting
system anatomy and kidney stone location during endoscopic surgery. The endpoint of this R21 will be a fully
validated navigational system for endoscopic stone surgery and the necessary experimental data to power a
large-scale, multi-center clinical trial. As our navigational system would require only software integration to
current endoscopic surgical cameras, all existing endoscopic surgical systems could in principle immediately
benefit from the results of this project. In this way, we believe the success of our project will facilitate improved
stone-free rates and mitigate repeat interventions or complications, benefiting patients, surgeons, and society.

## Key facts

- **NIH application ID:** 10833656
- **Project number:** 5R21DK133742-02
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Nicholas L Kavoussi
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $190,649
- **Award type:** 5
- **Project period:** 2023-05-01 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10833656

## Citation

> US National Institutes of Health, RePORTER application 10833656, A Navigational System for Endoscopic Kidney Stone Surgery (5R21DK133742-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10833656. Licensed CC0.

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