Nisha Patel1,2, Carlo A Seneci3, Jianzhong Shang3, Konrad Leibrandt3, Guang-Zhong Yang3, Ara Darzi3,4, Julian Teare3,4. 1. The Hamlyn Centre, Institute of Global Health Innovation, St. Mary's Hospital, Imperial College London, London, UK. nishakpatel1@gmail.com. 2. Department of Surgery and Cancer, St. Mary's Hospital, Imperial College London, London, UK. nishakpatel1@gmail.com. 3. The Hamlyn Centre, Institute of Global Health Innovation, St. Mary's Hospital, Imperial College London, London, UK. 4. Department of Surgery and Cancer, St. Mary's Hospital, Imperial College London, London, UK.
Abstract
BACKGROUND: Endoluminal therapeutic procedures such as endoscopic submucosal dissection are increasingly attractive given the shift in surgical paradigm towards minimally invasive surgery. This novel three-channel articulated robot was developed to overcome the limitations of the flexible endoscope which poses a number of challenges to endoluminal surgery. The device enables enhanced movement in a restricted workspace, with improved range of motion and with the accuracy required for endoluminal surgery. OBJECTIVE: To evaluate a novel flexible robot for therapeutic endoluminal surgery. DESIGN: Bench-top studies. SETTING: Research laboratory. INTERVENTION: Targeting and navigation tasks of the robot were performed to explore the range of motion and retroflexion capabilities. Complex endoluminal tasks such as endoscopic mucosal resection were also simulated. MAIN OUTCOME MEASUREMENTS: Successful completion, accuracy and time to perform the bench-top tasks were the main outcome measures. RESULTS: The robot ranges of movement, retroflexion and navigation capabilities were demonstrated. The device showed significantly greater accuracy of targeting in a retroflexed position compared to a conventional endoscope. LIMITATIONS: Bench-top study and small study sample. CONCLUSIONS: We were able to demonstrate a number of simulated endoscopy tasks such as navigation, targeting, snaring and retroflexion. The improved accuracy of targeting whilst in a difficult configuration is extremely promising and may facilitate endoluminal surgery which has been notoriously challenging with a conventional endoscope.
BACKGROUND: Endoluminal therapeutic procedures such as endoscopic submucosal dissection are increasingly attractive given the shift in surgical paradigm towards minimally invasive surgery. This novel three-channel articulated robot was developed to overcome the limitations of the flexible endoscope which poses a number of challenges to endoluminal surgery. The device enables enhanced movement in a restricted workspace, with improved range of motion and with the accuracy required for endoluminal surgery. OBJECTIVE: To evaluate a novel flexible robot for therapeutic endoluminal surgery. DESIGN: Bench-top studies. SETTING: Research laboratory. INTERVENTION: Targeting and navigation tasks of the robot were performed to explore the range of motion and retroflexion capabilities. Complex endoluminal tasks such as endoscopic mucosal resection were also simulated. MAIN OUTCOME MEASUREMENTS: Successful completion, accuracy and time to perform the bench-top tasks were the main outcome measures. RESULTS: The robot ranges of movement, retroflexion and navigation capabilities were demonstrated. The device showed significantly greater accuracy of targeting in a retroflexed position compared to a conventional endoscope. LIMITATIONS: Bench-top study and small study sample. CONCLUSIONS: We were able to demonstrate a number of simulated endoscopy tasks such as navigation, targeting, snaring and retroflexion. The improved accuracy of targeting whilst in a difficult configuration is extremely promising and may facilitate endoluminal surgery which has been notoriously challenging with a conventional endoscope.
Keywords:
Colorectal cancer; GI cancer; General endoscopy; Gut; Technical endoscopy; Therapeutic/Palliation endoscopy
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