Tsutomu Iwasa1,2,3, Ryu Nakadate4, Shinya Onogi5, Yasuharu Okamoto6, Jumpei Arata7, Susumu Oguri8, Haruei Ogino9, Eikichi Ihara9, Kenoki Ohuchida10, Tomohiko Akahoshi8, Tetsuo Ikeda8, Yoshihiro Ogawa9, Makoto Hashizume5,4,8. 1. Division of Minimally Invasive Advanced Medical Science, Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan. tiwasa@intmed3.med.kyushu-u.ac.jp. 2. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. tiwasa@intmed3.med.kyushu-u.ac.jp. 3. Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. tiwasa@intmed3.med.kyushu-u.ac.jp. 4. Division of Research Project, Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan. 5. Division of Minimally Invasive Advanced Medical Science, Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan. 6. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 7. Department of Mechanical Engineering, Faculty of Engineering, Kyushu University, Fukuoka, Japan. 8. Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. 9. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 10. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Abstract
BACKGROUND: Difficulties in endoscopic operations and therapeutic procedures seem to occur due to the complexity of operating the endoscope dial as well as difficulty in performing synchronized movements with both hands. We developed a prototype robotic-assisted flexible endoscope that can be controlled with a single hand in order to simplify the operation of the endoscope. The aim of this study was to confirm the operability of the robotic-assisted flexible endoscope (RAFE) by performing endoscopic submucosal dissection (ESD). METHODS: Study 1: ESD was performed manually or with RAFE by an expert endoscopist in ex vivo porcine stomachs; six operations manually and six were performed with RAFE. The procedure time per unit circumferential length/area was calculated, and the results were statistically analyzed. Study 2: We evaluated how smoothly a non-endoscopist can move a RAFE compared to a manual endoscope by assessing the designated movement of the endoscope. RESULTS: Study 1: En bloc resection was achieved by ESD using the RAFE. The procedure time was gradually shortened with increasing experience, and the procedure time of ESD performed with the RAFE was not significantly different from that of ESD performed with a manual endoscope. Study 2: The time for the designated movement of the endoscope was significantly shorter with a RAFE than that with a manual endoscope as for a non-endoscopist. CONCLUSIONS: The RAFE that we developed enabled an expert endoscopist to perform the ESD procedure without any problems and allowed a non-endoscopist to control the endoscope more easily and quickly than a manual endoscope. The RAFE is expected to undergo further development.
BACKGROUND: Difficulties in endoscopic operations and therapeutic procedures seem to occur due to the complexity of operating the endoscope dial as well as difficulty in performing synchronized movements with both hands. We developed a prototype robotic-assisted flexible endoscope that can be controlled with a single hand in order to simplify the operation of the endoscope. The aim of this study was to confirm the operability of the robotic-assisted flexible endoscope (RAFE) by performing endoscopic submucosal dissection (ESD). METHODS: Study 1: ESD was performed manually or with RAFE by an expert endoscopist in ex vivo porcine stomachs; six operations manually and six were performed with RAFE. The procedure time per unit circumferential length/area was calculated, and the results were statistically analyzed. Study 2: We evaluated how smoothly a non-endoscopist can move a RAFE compared to a manual endoscope by assessing the designated movement of the endoscope. RESULTS: Study 1: En bloc resection was achieved by ESD using the RAFE. The procedure time was gradually shortened with increasing experience, and the procedure time of ESD performed with the RAFE was not significantly different from that of ESD performed with a manual endoscope. Study 2: The time for the designated movement of the endoscope was significantly shorter with a RAFE than that with a manual endoscope as for a non-endoscopist. CONCLUSIONS: The RAFE that we developed enabled an expert endoscopist to perform the ESD procedure without any problems and allowed a non-endoscopist to control the endoscope more easily and quickly than a manual endoscope. The RAFE is expected to undergo further development.
Authors: Khek-Yu Ho; Soo Jay Phee; Asim Shabbir; Soon Chiang Low; Van An Huynh; Andy Prima Kencana; Kai Yang; Davide Lomanto; Bok Yan Jimmy So; Y Y Jennie Wong; S C Sydney Chung Journal: Gastrointest Endosc Date: 2010-06-19 Impact factor: 9.427
Authors: Hendrikus J M Pullens; Nanda van der Stap; Esther D Rozeboom; Matthijs P Schwartz; Ferdi van der Heijden; Martijn G H van Oijen; Peter D Siersema; Ivo A M J Broeders Journal: Endoscopy Date: 2015-06-30 Impact factor: 10.093
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Authors: Esther D Rozeboom; Barbara A Bastiaansen; Elsemieke S de Vries; Evelien Dekker; Paul A Fockens; Ivo A M J Broeders Journal: Gastrointest Endosc Date: 2015-11-10 Impact factor: 9.427