Kidney stones are collections of crystals formed from minerals and other substances in the urinary tract. Some small kidney stones can pass naturally through the urine, although the process may sometimes cause pain. If a stone is too large to pass on its own or causes a blockage in the urinary tract, the patient may require a medical procedure to break it down or remove it.
With advances in medical technology, kidney stones can now be treated with the assistance of robotic technology. One such option is available at Mandaya Royal Puri Hospital through the Zamenix robot, which is controlled by a urologist to help break down kidney stones measuring up to 2 cm without open surgery. So, what are some interesting facts about robotic kidney stone treatment?
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Getting to Know Zamenix: A Robotic Arm System for Breaking Up and Removing Kidney Stones
Zamenix is a robotic technology designed to assist in treating kidney stones without incisions. It features a flexible robotic arm equipped with a high-resolution camera, helping doctors visualize and locate kidney stones, including those in hard-to-reach areas.
To break down kidney stones, Zamenix uses a thulium laser that fragments stones into smaller pieces. The technology is also equipped with a specialized grasper to help retrieve the remaining fragments after the stones have been broken down. These capabilities allow the robot to assist in treating large kidney stones, including those measuring more than 2 cm in diameter, depending on the doctor’s evaluation and clinical judgment.
During the procedure, the robotic arm is inserted through the urinary tract and guided toward the kidney, eliminating the need for an incision in the patient’s body. The robot’s movements are controlled by the doctor using a dedicated cockpit controller, with real-time monitoring throughout the procedure. This system helps doctors guide the instruments and monitor the treatment process in a more controlled manner.
Interesting Facts About Robotic Kidney Stone Treatment at Mandaya Royal Puri Hospital
Here are some interesting facts about kidney stone treatment using the Zamenix robot at Mandaya Royal Puri Hospital.
1. No Open Surgery, No Incisions: The Robotic Arm Enters Through the Urinary Tract
Kidney stone treatment using the Zamenix robot is performed without open surgery or incisions in the body. The robotic arm, equipped with a camera and specialized instruments, is inserted through the urethra, the tube through which urine leaves the body. It is then guided through the bladder and toward the kidney. Using this route, doctors can break down stones with a thulium laser and help remove the fragments without making incisions in the patient’s skin.
2. More Precise Instrument Control
Zamenix features a dedicated control system that helps doctors maneuver the camera, laser, and kidney stone grasper in a more controlled manner. The technology helps minimize the effects of hand tremors and operator fatigue, particularly during lengthy kidney stone fragmentation procedures.
3. Adapting Instrument Movements to the Patient’s Breathing
A patient’s body movements during breathing can affect the position of the kidneys and the stones within them. Zamenix has a feature that helps adjust instrument movements in response to the patient’s breathing. This helps maintain a more stable distance between the laser tip and the kidney stone during fragmentation.
4. Remembering the Route to the Kidney Stone
Zamenix has a feature that allows the system to save the route to an area of the kidney that has been reached by the camera or endoscope. If the instrument needs to be temporarily withdrawn, the system can help guide it back to the previously saved location. This feature also assists in retrieving stone fragments after fragmentation, helping the procedure proceed more efficiently.
5. Helping Determine Which Stone Fragments Can Be Safely Removed
Zamenix includes a feature that guides doctors in determining the size of stone fragments that can be removed through the urinary tract. If a doctor grasps a fragment that is too large, the system provides a warning. This feature helps doctors avoid removing fragments that could injure the ureter, the tube connecting the kidney to the bladder.
6. The Only One in Indonesia and Southeast Asia
The Zamenix robot available at Mandaya Royal Puri Hospital is described as the only robotic technology for kidney stone treatment in Indonesia and Southeast Asia. It helps urologists break down and retrieve kidney stones through the urinary tract without incisions, using a flexible robotic arm, a high-resolution camera, and a thulium laser.
7. Performed by Urologists Experienced in Robotic Surgery
Kidney stone treatment using the Zamenix robot at Mandaya Royal Puri Hospital is performed by urologists with expertise in robotic surgical technology. One of them is Prof. dr. Ponco Birowo, Sp.U.(K), Ph.D., who has experience in urology and the use of robotic technology to help treat various urinary tract conditions. This expertise supports the targeted use of robotic technology according to each patient’s medical condition and treatment needs.
Recognizing the Often-Overlooked Symptoms of Kidney Stones
Kidney stones usually do not cause symptoms until they move within the kidney or enter one of the ureters. The ureters are tubes that connect the kidneys to the bladder.
If a kidney stone becomes lodged in a ureter, urine flow may become obstructed, causing the kidney to swell and the ureter to spasm. This can lead to severe pain. Symptoms may include:
- Sharp, severe pain in the side or back, just below the ribs.
- Pain that radiates to the lower abdomen and groin.
- Pain that comes and goes in waves, with varying levels of severity.
- Pain or a burning sensation when urinating.
Other symptoms may include:
- Pink, red, or brown urine due to the presence of blood.
- Cloudy or foul-smelling urine.
- A persistent urge to urinate, urinating more frequently than usual, or passing only small amounts of urine.
- Nausea and vomiting.
- Fever and chills if an infection develops.
Pain caused by kidney stones may change as the stones move through the urinary tract. For example, the location of the pain may shift to another part of the body, or the pain may become more severe.
When Should You See a Doctor?
Make an appointment with a doctor if you experience concerning symptoms that may be related to kidney stones.
Seek medical attention promptly if you experience any of the following:
- Severe pain that makes it difficult to sit still or find a comfortable position.
- Pain accompanied by nausea and vomiting.
- Pain accompanied by fever and chills.
- Blood in the urine.
- Difficulty urinating or an inability to pass urine.
Facilities for Out-of-Town and International Patients at Mandaya Royal Puri Hospital
Mandaya Royal Hospital Puri provides various support services to ensure greater comfort for patients traveling from other cities or countries.
- VIP Transportation: A pickup service from Soekarno-Hatta International Airport, train stations, or seaports to the hospital in a comfortable vehicle, accompanied by a Patient Experience Officer (PEO).
- Medical Ambulance Pickup: A specialized pickup service for patients with specific medical needs from their arrival point (airport, train station, or seaport). The service includes medical equipment and assistance from professional healthcare personnel.
- Accommodation (Sleep Hub & Apartments): Comfortable accommodation for families accompanying patients, located on the eighth floor of the Mandaya Royal Puri Hospital building, as well as options for nearby apartments.
- International Patient Relations: Dedicated assistance for international patients with medical coordination, interpretation, and administrative arrangements. For information and assistance, contact 021 5092 8888 or email [email protected].
To make your visit to Mandaya Royal Hospital Puri easier, use the WhatsApp chat feature, Book Appointment service, or the Care Dokter application, available for download on Google Play and the App Store. These options can help you manage appointments, check queue numbers, and access other relevant information.
The information on this page is provided for educational purposes and as a general overview. It does not represent the full range of medical services that each doctor may perform. To ensure appropriate care for your specific health condition, we recommend consulting the relevant doctor directly.
If you have any questions, suggestions, or need further information, please contact our call center at 0811-1900-2000.
References:
- Cleveland Clinic. Kidney Stones. (https://my.clevelandclinic.org/health/diseases/15604-kidney-stones). Accessed October 26, 2026.
- ROEN Surgical. Zamenix. (https://www.roensurgical.com/en/zamenix?ckattempt=1). Accessed October 26, 2026.
- Mayo Clinic. Kidney Stones – Symptoms and Causes. (https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755). Accessed October 26, 2026.