Kyle Wood, M.D., MBA, associate professor in the UAB Department of Urology, is pioneering a new handheld robotic ultrasound-guidance device that changes how physicians access the kidney during stone surgery. The technology is designed to help surgeons precisely target the kidney, usually one of the more technically challenging steps. For Wood, this has allowed for smaller incisions, less trauma to the kidneys, and quicker recovery times.
Kyle Wood, M.D., MBA
“Prior to this device, one of the most difficult parts of the percutaneous nephrolithotomy, or PCNL surgery was gaining access to the kidney,” Wood said. “The challenge is that the kidney is surrounded by other organs and blood vessels, so the surgeon needs to hit a very specific target while avoiding structures that could be injured. This new technology helps guide that process and has revolutionized how I approach one of the most critical steps in the procedure.”
Understanding conventional kidney stone treatments
The Department of Urology currently offers a full spectrum of kidney stone treatments to address a condition that is especially common in the Southeast.
“Epidemiological research estimates that approximately 11 percent of U.S. men and 6 percent of U.S. women experience kidney stones at least once in their lifetime,” Wood said.
According to Wood, those rates are even higher in Alabama, which is part of the region often called the “Kidney Stone Belt”.
There are four main treatment options for kidney stones:
- Observation and medication. For a small stone likely to pass on its own, the patient may choose to try to monitor at home with the aid of medication.
- Shockwave Lithotripsy. A machine outside the body can generate focused shockwaves to break the stone into smaller pieces which can then pass through the urinary tract.
- A urologist passes a small scope through the urinary tract into the ureter or kidney to treat the stone with instruments and lasers.
- Percutaneous Nephrolithotomy. For larger or more complex stones, surgeons may create a small incision and tract in the back to directly access the kidney and treat the stone.
How does the device work?
Surgeons use X-ray guidance, known as fluoroscopy, ultrasound or a combination of the two to guide needle placement during percutaneous nephrolithotomy.
The new technology combines handheld robotics, real-time ultrasound imaging and guidance software to help surgeons plan and maintain the needle’s path into the kidney. “It is designed to make a technically difficult part of kidney-stone surgery more precise and with less risk”, Wood explained.
Wood noted the new technology has helped him provide a surgery with four new advantages relative to prior:
- Reduced reliance on fluoroscopy. Ultrasound guidance can reduce or eliminate the need for fluoroscopy during kidney access, thus reducing the exposure to patient, surgeon and staff.
- Flexible patient positioning. The approach supports different patient positioning, creating both convenience for the surgical team and less risk for the patient.
- Real-time visualization. The handheld robotic ultrasound guidance system increases precision, providing improved visualization of surrounding structures and the kidney
- Targeted needle placement. The robotic alignment and guidance optimizes access to kidney, reducing trauma and improving recovery times.
With the new technology, many of Wood’s procedures that once required an overnight stay are now same-day procedures, and many do not require an external tube to drain the kidney. This innovation enables greater safety and accuracy in a highly precise procedure.
“This technology is one of many ways our urology department is staying at the forefront of kidney stone care,” Wood said. “The goal has always been to provide the very best care for our patients afflicted with kidney stones, and this device is helping us deliver on that goal.”