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

Sang Hyun Kim, Byung Gon Kim, Hyuk Soon Choi, Daehie Hong, Se Hyun Jang, Kihun Hong, Jin Woo Choi, Seung Han Kim, Jae Min Lee, Eun Sun Kim, Bora Keum, Yoon Tae Jeen, Hong Sik Lee, Hoon Jai Chun

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Appropriate tissue tension and clear visibility of the dissection area using traction are essential for effective and safe endoscopic submucosal dissection (ESD). We developed a robotic assistive traction device for flexible endoscopy and compared its safety and efficiency in ESD between experienced and novice endoscopists. Methods: Robotic ESD was performed by experienced and novice endoscopist groups (n = 2, each). The outcomes included time to complete each ESD step, total procedure time, size of the dissected mucosa, rate of en bloc resection, and major adverse events. Furthermore, incision and dissection speeds were compared between groups. Results: Sixteen gastric lesions were resected from nine live pigs. The submucosal incision speed was significantly faster in the expert group than in the novice group (P = 0.002). There was no significant difference in the submucosal dissection speed between the groups (P = 0.365). No complications were reported in either group. Conclusions: When the robot was assisting in the ESD procedure, the dissection speed improved significantly, especially in the novice surgeons. Our robotic device can provide simple, effective, and safe multidirectional traction during ESD.

Original languageEnglish
JournalSurgical Endoscopy
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • Endoscopic submucosal dissection
  • Flexible endoscopy
  • Robot
  • Robotic-assisted flexible endoscope

ASJC Scopus subject areas

  • Surgery

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