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Updated: Jun 14, 2026
Surgical Robot-Assisted Transanal Specimen Extraction Radical Sigmoidectomy Without an Auxiliary Abdominal Incision
Published on: June 13, 2025
A Prospective Trial on Operability and Safety of a Simplified Robot-Assisted System (FASTER) for Colorectal
Han Bu1,2, Xinyu Zhang1,2, Ciliang Jin1
1Department of Gastroenterology and Hepatology.
Background And Aims:
One of the key challenges in endoscopic submucosal dissection (ESD) is achieving effective intraoperative mucosal traction. Although numerous countertraction technologies have been developed, there is still room for optimization. This randomized controlled trial was designed to assess the comparative effectiveness of a novel robotic assistance system (FASTER) versus conventional ESD techniques for managing colorectal neoplasia.
Methods:
A total of 24 ESD procedures were performed on 6 different anatomic sites (rectum and sigmoid colon) of 4 pigs. Twelve procedures were performed with the FASTER-assisted method and 12 with the conventional method. Key efficacy outcomes consisted of total procedure time, submucosal dissection time, submucosal dissection speed, and direct visual dissection rate. Secondary outcomes evaluated the complete resection rate and perioperative adverse events.
Results:
Compared with the conventional ESD group (C-ESD), the total procedure time of the FASTER-assisted ESD group (F-ESD) was significantly lower (11.5 vs. 18.0 min; P <0.001). Compared with the conventional ESD, FASTER-assisted ESD significantly increased the submucosal dissection speed (0.7 vs. 0.4 cm 2 /min; P <0.001), shortened the submucosal dissection time (4.9 vs. 10.7 min; P <0.001), and improved the rate of direct vision dissection (99.0% vs. 83.2%; P <0.001). The operation difficulty score of the F-ESD group was significantly lower than that of the C-ESD group (1.0 vs. 3.0; P <0.001). FASTER-assisted ESD significantly optimized the primary outcome measures in the treatment of sigmoid and rectal lesions.
Conclusions:
The FASTER system reliably provided continuous visual feedback and dynamic tissue manipulation throughout the ESD procedure. In this prospective preclinical animal investigation, it significantly shortened operation time and reduced surgical adverse events, offering an innovative solution for optimizing ESD procedures in colorectal treatment.
