Endoscopic submucosal dissection using a detachable assistant robot: a comparative in vivo feasibility study (with...

Area of Science:

• Gastroenterology
• Surgical Robotics
• Endoscopic Procedures

Background:

• Effective endoscopic submucosal dissection (ESD) requires optimal tissue tension and clear visualization.
• Traction is crucial for safe and efficient ESD procedures.
• A novel robotic assistive traction device for flexible endoscopy was developed.

Purpose of the Study:

• To evaluate the safety and efficiency of a robotic assistive traction device in ESD.
• To compare the performance of experienced and novice endoscopists using the device.
• To assess the impact of robotic assistance on ESD procedure outcomes.

Main Methods:

• Robotic ESD procedures were conducted by two groups of endoscopists (experienced and novice).
• Key outcomes measured included time for ESD steps, total procedure time, resected tissue size, en bloc resection rate, and adverse events.
• Incision and dissection speeds were compared between the experienced and novice groups.

Main Results:

• Sixteen gastric lesions were resected in live pigs.
• Submucosal incision speed was significantly faster in the expert group (P=0.002).
• No significant difference in submucosal dissection speed was observed between groups (P=0.365), and no complications occurred.

Conclusions:

• Robotic assistance significantly improved ESD dissection speed, especially for novice surgeons.
• The developed robotic device offers simple, effective, and safe multidirectional traction for ESD.
• This technology holds promise for enhancing ESD procedures.