A Novel Retractable Robotic Device for Colorectal Endoscopic Submucosal Dissection.

Area of Science:

• Gastroenterology
• Surgical Robotics
• Endoscopic Procedures

Background:

• Effective endoscopic submucosal dissection (ESD) relies on optimal tissue tension and clear visibility, often achieved through traction.
• Conventional traction methods can be challenging, impacting the safety and efficiency of colorectal ESD.

Purpose of the Study:

• To develop and evaluate a novel retractable robot-assisted traction device for colorectal ESD.
• To assess the device's impact on procedure time, dissection speed, and safety compared to conventional methods.

Main Methods:

• ESD was performed 18 times on ex vivo porcine colon using the robot-assisted device and 18 times using conventional methods.
• Key outcome measures included total procedure time, dissection speed, and blind dissection rate.
• An in vivo porcine feasibility study was also conducted to assess device insertion and performance.

Main Results:

• Robot-assisted ESD (RESD) demonstrated significantly shorter procedure times (20.1 min vs 34.3 min) and faster dissection speeds (36.8 mm²/min vs 18.1 mm²/min) compared to conventional ESD (CESD).
• The blind dissection rate was significantly lower in the RESD group (12.8% vs 35.1%).
• The robotic device was successfully inserted and utilized in vivo without adverse events.

Conclusions:

• The retractable robot-assisted traction device significantly enhances dissection speed and safety in colonic ESD.
• This robotic system offers a promising solution for providing simple, effective, and safe multidirectional traction during colonic ESD.