In vitro development of the Autonomous Colonoscope Robot System (ACRS) for fully automated colonoscope insertion

Area of Science:

• Robotics in Medicine
• Gastroenterology
• Medical Device Development

Background:

• Robotic systems are being developed for colonoscopy to address the shortage of trained endoscopists.
• The Autonomous Colonoscope Robot System (ACRS) was created to explore autonomous colonoscope insertion.
• ACRS is based on the Endoscopic Operation Robot version 4.

Purpose of the Study:

• To evaluate if expert-derived operational data can enable autonomous colonoscope insertion.
• To assess the feasibility of the ACRS in a controlled colonoscopy training model.
• To compare automated insertion times with manual insertions.

Main Methods:

• ACRS was trained using expert endoscopist data on a standardized colonoscopy model.
• Automated insertions were evaluated in a controlled configuration (Pattern 1) without significant loop formation.
• Completely automated insertions were classified as Level 4, and those needing assistance as Level 3.

Main Results:

• The ACRS achieved an 86.1% success rate for automated insertions (Level 3 or higher).
• Level 4 automated insertions averaged 2.92 ± 1.20 minutes.
• Automated insertion times were longer than expert manual insertions but comparable to trainee times.

Conclusions:

• The ACRS demonstrates proof-of-concept for autonomous colonoscope insertion in simplified, controlled environments.
• Further validation is necessary in more complex models, animal studies, and clinical settings.
• Translational application of ACRS requires extensive further research and development.