Gut Liver.  2019 Jul;13(4):402-408. 10.5009/gnl18370.

A Pilot Study of Endoscopic Submucosal Dissection Using an Endoscopic Assistive Robot in a Porcine Stomach Model

• Kim BG
• Choi HS
• Park SH
• Hong JH
• Lee JM
• Kim SH
• Chun HJ
• Hong D
• Keum B

• KMID: 2458523
• DOI: http://doi.org/10.5009/gnl18370

Abstract

BACKGROUND/AIMS
Endoscopic assistive devices have been developed to reduce the complexity and improve the safety of surgeries involving the use of endoscopes. We developed an assistive robotic arm for endoscopic submucosal dissection (ESD) and evaluated its efficiency and safety in this in vitro pilot study.
METHODS
ESD was performed using an auxiliary transluminal endoscopic robot. An in vitro test bed replicating the intra-abdominal environment and pig stomachs were used for the experiment. Participants were divided into skilled operators and unskilled operators. Each group performed ESD 10 times by using both conventional and robot-assisted methods. The perforation incidence, operation time, and resected mucous membrane size were measured.
RESULTS
For the conventional method, significant differences were noted between skilled and unskilled operators regarding operation time (11.3 minutes vs 26.7 minutes) and perforation incidence (0/10 vs 6/10). Unskilled operators showed a large decrease in the perforation incidence with the robot-assisted method (conventional method vs robot-assisted method, 6/10 vs 1/10). However, the operation time did not differ between the conventional and robot-assisted methods. On the other hand, skilled operators did not show differences in the operation time and perforation incidence between the conventional and robot-assisted methods. Among both skilled and unskilled operators, the operation time decreased with the robot-assisted method as the experiment proceeded.
CONCLUSIONS
The surgical safety of unskilled operators greatly improved with robotic assistance. Thus, our assistive robotic arm was beneficial for ESD. Our findings suggest that endoscopic assistive robots have positive effects on surgical safety.

Keyword

Endoscopic mucosal resection; Endoscopy; Pilot projects; Surgery, computer-assisted

MeSH Terms

Arm
Endoscopes
Endoscopy
Hand
In Vitro Techniques
Incidence
Methods
Mucous Membrane
Pilot Projects*
Self-Help Devices
Stomach*
Surgery, Computer-Assisted