Endoluminal surgical triangulation 2.0: A new flexible surgical robot. Preliminary pre‐clinical results with colonic submucosal dissection

Légner, András; Diana, Michele; Halvax, Péter; Liu, Yuyin; Zorn, Lucile; Zanne, Philippe; Nageotte, Florent; Mathelin, Michel de; Dallemagne, Bernard; Marescaux, Jacques

doi:10.1002/rcs.1819

Cited by 47 publications

(33 citation statements)

References 35 publications

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“…Future applications and developments of endoscopy robots will be in high‐resolution imaging, 3‐D vision, advanced optical analytics, 3‐D modeling algorithms, drug delivery, implementation of lasers and ultrasound. An interesting point in the development of endoscopy robots is autonomous locomotion, a field where much work has been done, but is still in its initial phase . As it concerns costs, the good point is that health systems around the globe are becoming more cost conscious and, hopefully, this will lead to widespread technology .…”

Section: Discussionmentioning

confidence: 99%

“…The workplace in front of the camera is concentrated in a 9‐cm working field. Effectiveness of the STRAS system has been evaluated during 18 rectal ESD procedures on eight pigs . Twelve out of the 18 ESD were successfully completed.…”

Section: Isis‐scope/stras Systemmentioning

confidence: 99%

“…Effectiveness of the STRAS system has been evaluated during 18 rectal ESD procedures on eight pigs. 22 Twelve out of the 18 ESD were successfully completed. Among the completed procedures, two perforations and one system failure occurred and were managed intraoperatively.…”

Section: Isis-scope/stras Systemmentioning

confidence: 99%

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Endoscopy robotics: Current and future applications

Boškoski

Costamagna

2018

Digestive Endoscopy

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Many different types of endoscopy robot have been developed or are under development. Some of these innovative biotechnologies are dedicated to complex endoscopic procedures such as endoscopic submucosal dissection whereas others are purely diagnostic. In endoscopy robotics, there are still several problems that need a solution. These problems basically concern robotic locomotion and instrument control, as well as clinical application. In most cases, the technology is still under development. The current fields of investigation are augmented reality, advances in actuation and reduction of hysteresis, optical analysis, wireless movement transmission and many others. Besides endoscopic submucosal dissection, other promising fields of implementation of endoscopy robots are natural orifices transluminal endoscopic surgery and bariatric endoscopy. Obviously, endoscopy robots are expensive, but both doctors and health system providers are becoming more aware of the possibilities that these platforms can offer. Improvement of the performance of endoscopy robots undoubtedly will lead to their widespread use and, therefore, a balance in cost-effectiveness.

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Section: Discussionmentioning

confidence: 99%

Section: Isis‐scope/stras Systemmentioning

confidence: 99%

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Endoscopy robotics: Current and future applications

Boškoski

Costamagna

2018

Digestive Endoscopy

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“…Robotic technologies have overcome the limitations of these manual platforms facilitating intuitive and efficient multitasking control on the surgeon's side as well as the precise and intelligent movement of the robot on the patient's side. STRAS, MASTER, ViaCath, FLEX, i2Snake, and CYCLOPS systems have shown the possibility of advanced endoscopic surgery with their highly dexterous robotic arm. However, they also seem to have common difficulties in designing flexible manipulators with sufficient miniaturization and payload capability to perform various intraluminal surgical operations.…”

Section: Introductionmentioning

confidence: 99%

K‐FLEX: A flexible robotic platform for scar‐free endoscopic surgery

Hwang

Kwon

2020

Robotics Computer Surgery

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Background Despite its high lesion accessibility and versatility, endoscopic platforms have suffered from designing flexible manipulators with high payload capability sufficient to perform advanced endoscopic procedures. Methods A flexible robotic platform, K‐FLEX, has been developed with a design of 17 mm in overall diameter. To overcome the shape distortion and deflection in payload handling, a strong continuum manipulator has been designed to have maximum resistance to the distortion. The kinematic analysis and mapping strategy have been established for the master‐slave teleoperation. Results The proposed manipulator has shown 7.5 mm in trajectory variation to lift the weight of 300 g. Finally, the feasibility of the integrated K‐FLEX system has been verified through three kinds of simulated surgical tasks. Conclusions The initial prototype of the proposed robot showed the possibility of advanced endoscopic surgery with improved payload capability.

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“…Single‐access transluminal robotic assistant for surgeons (STRAS) system was developed by the University of Strasbourg for ESD surgery which had finished collaborative operation of endoscope and two surgical instruments in 12 animal experiments. However, the operator needs to manually insert the endoscope into the human body and then fixes the endoscope to the robotic operating part; hence, the forward and backward motions of the endoscope are difficult to realize during the whole robotic surgical operation . The Endoscopic Operation Robot system (EOR) and Advance Endoscopy system were all based on the operation of commercial digestive endoscope, and they had a good performance in animal and human phantom experiments.…”

Section: Introductionmentioning

confidence: 99%

Navigation strategy for robotic soft endoscope intervention

Jiang

Zhou

Wang

et al. 2019

Robotics Computer Surgery

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Background Current soft endoscope intervention mainly depends on the skills of endoscopists, especially for the orientation of the endoscope within the human tortuous lumen. This dependence causes inefficient and time‐consuming surgery. Methods A human‐robot cooperation navigation strategy is proposed to perform the intervention of soft endoscope. The navigation strategy firstly detects the cavity center by processing the image of endoscope, then an auto‐orienting strategy is presented to automatically adjust the endoscope pointing to the detected cavity center. Results Human phantom experiments are carried out to validate the effectiveness and feasibility of the navigation strategy. The results show that the cavity center is accurately extracted with whether the cavity is occluded or not and the auto‐orienting strategy could well point the endoscope around the cavity center. Conclusion The proposed human‐robot cooperation navigation strategy releases endoscopists from the time‐consuming operations and improves the safety and automation of intervention procedures.

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Endoluminal surgical triangulation 2.0: A new flexible surgical robot. Preliminary pre‐clinical results with colonic submucosal dissection

Abstract: Experimental colorectal ESDs using the flexible surgical robot were feasible and reflected a short learning curve. After some technical improvements the system might allow for a wider adoption of complex endoluminal surgical procedures.

Cited by 47 publications

References 35 publications

Endoscopy robotics: Current and future applications

Endoscopy robotics: Current and future applications

K‐FLEX: A flexible robotic platform for scar‐free endoscopic surgery

Navigation strategy for robotic soft endoscope intervention

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