Advancement in surgical management of urolithiasis has revolved around improvements in technology. Urologists have been at the forefront on embracing new technology and passing on the benefits to the patients. Da Vinci® robotic system has contributed significantly in improving the outcomes of minimally invasive procedures especially those requiring complex resections and reconstruction. Endourological and percutaneous techniques have established superiority in management of urolithiasis and majority of the patients are ideal candidates for such procedures. However, in certain stone disease indications like simultaneous pyeloplasty-pyelolithotomy, robotic assisted procedure has established superiority, at least in the developed world. Other indications like complex pyelolithotomy and stone extraction with simultaneous partial nephrectomy are being continuously documented. Large, multi-institutional studies to evaluate the effective advantages of the robotic approach against well-established methodologies in the treatment of stone disease are required. However the wider availability of robotic system in areas where stone disease is endemic continues to be the biggest challenge.
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