Margaret Knoedler, MD, on robot-assisted mini-PCNL with the MONARCH Platform

Data presented at the 2025 American Urological Association Annual Meeting in Las Vegas, Nevada, suggest that the Monarch Platform can offer extended capabilities for robot-assisted mini-PCNL while being safe and effective in the treatment of nephrolithiasis.¹

At the interim analysis of the study, 9 patients had successfully undergone mini-PCNL with the Monarch Platform through the University of Wisconsin.

The authors noted, “This is especially noteworthy at our institution, where participating urologists do not routinely gain percutaneous access independently, nor do we perform mini-PNCL with the patient in a modified supine position.”

Senior author Margaret A. Knoedler, MD, recently spoke with Urology Times® about the benefits of the device compared with traditional PCNL. Knoedler is a urologist at University of Wisconsin Health and an assistant professor of medicine at the University of Wisconsin School of Medicine and Public Health.

The median duration of the procedure was 220 minutes. Among the 9 patients treated, the median reduction in volume of stone burden was 98% per CT scan at POD30.

Grade 1 and 2 adverse events (AEs) were in line with what was expected with this procedure and included bladder spasm, dysuria, hematuria, flank pain, and penile pain. There was 1 grade 3 AE recorded, which was a case of post-operative fluid accumulation requiring drainage.

Overall, Knoedler concluded, “I think we're going to see an explosion in technology, including artificial intelligence, using both the laser technology and the robotic technology, to help improve stone treatment for our patients.”

REFERENCE

1. Blumenthal ZA, Serrell EC, Sehgel NL, et al. Clinical outcomes for the robotic-assisted mini-percutaneous nephrolithotomy with the Monarch Platform, urology. J Clin Oncol. 2025;213(5S):e422. doi:10.1097/01.JU.0001109856.11315.1d.15