Gastric endoscopic submucosal dissection using novel 2.6-mm articulating devices: an ex vivo comparative and in vivo feasibility study

Nakadate, Ryu; Nakamura, Shotaro; Moriyama, Tomohiko; Kenmotsu, Hajime; Oguri, Susumu; Arata, Jumpei; Uemura, Munenori; Ohuchida, Kenoki; Akahoshi, Tomohiko; Ikeda, Tetsuo; Hashizume, Makoto

doi:10.1055/s-0034-1391438

Cited by 18 publications

(22 citation statements)

References 9 publications

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“…Flexible endoscopy platforms are classified into two groups with remote forceps operation and assisted endoscope operation (manipulation of flexible endoscopes themselves). The MASTER [1–3], EndoSAMURAI [4–6], 3D-printed overtube system [12], and 2.6 mm articulating devices [13] are included in the former. EOR and the robotic-assisted flexible endoscope (RAFE) [14] are included in the latter.…”

Section: Discussionmentioning

confidence: 99%

Development of a Novel Gastrointestinal Endoscopic Robot Enabling Complete Remote Control of All Operations: Endoscopic Therapeutic Robot System (ETRS)

Kume

Sakai

Ueda

2019

Gastroenterology Research and Practice

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Background and Objective The master and slave transluminal endoscopic robot and other flexible endoscopy platforms are designed primarily for the remote control of forceps, with manipulation of the endoscope itself still dependent on conventional techniques. We have developed an endoscopic therapeutic robot system (ETRS) that provides complete remote control of all forceps and endoscope operations. Method We carried out endoscopic submucosal dissection (ESD) in porcine stomachs using the ETRS. All procedures were completed with the endoscopist seated at the console the entire time. Results Total en bloc resection was achieved in all 7 cases with no complications. The mean total procedure time was 36.14 ± 14.98 min, the mean size of the resected specimen was 3.39 ± 0.66 cm × 3.03 ± 0.63 cm, and the mean dissection time was 14.91 ± 8.61 min. Conclusion We successfully used the ETRS to perform completely remote-controlled ESD in porcine stomachs.

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Section: Discussionmentioning

confidence: 99%

Development of a Novel Gastrointestinal Endoscopic Robot Enabling Complete Remote Control of All Operations: Endoscopic Therapeutic Robot System (ETRS)

Kume

Sakai

Ueda

2019

Gastroenterology Research and Practice

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“…Nakadate and colleagues developed new articulating devices and performed an ex vivo comparative study. 58 Gastric ESD using these new devices resulted in significantly shorter procedure durations among inexperienced providers but no difference among experts. These traction methods maintain adequate visualization of the dissection plane during ESD which is often the rate-limiting step and is regarded as one of the most difficult aspects of the procedure.…”

Section: Reducing the Learning Curve: New Techniques And Technologiesmentioning

confidence: 96%

“…These traction methods maintain adequate visualization of the dissection plane during ESD which is often the rate-limiting step and is regarded as one of the most difficult aspects of the procedure. 58,59 Recently, robotic-assisted endoscopic surgery platform (Fig. 5) has been designed to improve precision, effectiveness, safety, and reliability, as well as to enhance the interventional capabilities of endoscopists carrying out ESD.…”

Section: Reducing the Learning Curve: New Techniques And Technologiesmentioning

confidence: 99%

Current state of education and training for endoscopic submucosal dissection: Translating strategy and success to the USA

McCarty

Aihara

2020

Digestive Endoscopy

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Endoscopic submucosal dissection (ESD) is a rigorous and technically sophisticated method for removal of lesions within the gastrointestinal tract. Despite having advantages of en‐bloc resection of lesions, regardless of size, and widespread use in Japan and Asia, ESD has not become widely adopted in the USA for a variety of reasons. Based upon Japanese education and the master‐apprentice model, modification to the education system and additional techniques designed to facilitate broader adoption are required for trainees in the USA. This article will review the current state of education and training for ESD in the USA.

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“…We have also been developing flexible endoscopic platforms for ESD in manually driven version [47,48] (Figure 10) and motorized version [49] (Figure 11). They composed of conventional flexible endoscope, two 2.6-mm articulating instruments, and an additional channel.…”

Section: Kyushu University Esd Robotmentioning

confidence: 99%

“…Control part on a stand is designed, so that both handles of the instruments and endoscope are close to the operator. Animal experiments have been carried out [47,48].…”

Section: Kyushu University Esd Robotmentioning

confidence: 99%

Intelligent Information-Guided Robotic Surgery

Nakadate¹,

Hashizume²

2018

Recent Advances in Laparoscopic Surgery [Working Title]

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Laparoscopic surgery is minimally invasive, providing various benefits for patients. On the other hand, it is technically demanding for physicians due to limited dexterity of tools, limited vision. In order to cope with those limitations, recent various engineering technologies are trying to help surgeon. Robotics is one of the major technologies in this field. Until today, da Vinci has been only one such robot. But recently, many other robotic systems are under development. Those new robots are introduced in this chapter first. Other than robotics, or in conjunction with robotics, navigation technologies are getting popularity in clinical use. Navigation is a technology that provides useful information such as preoperative images or distance between tool and lesion, etc. to surgeon. Our experience in clinical use of navigation system in robotic surgery is introduced. Finally, technologies applied for the training of surgeon are introduced and described.

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Gastric endoscopic submucosal dissection using novel 2.6-mm articulating devices: an ex vivo comparative and in vivo feasibility study

Abstract: ESD using novel articulating devices was feasible. These devices were able to reduce the procedure time for novices.

Cited by 18 publications

References 9 publications

Development of a Novel Gastrointestinal Endoscopic Robot Enabling Complete Remote Control of All Operations: Endoscopic Therapeutic Robot System (ETRS)

Development of a Novel Gastrointestinal Endoscopic Robot Enabling Complete Remote Control of All Operations: Endoscopic Therapeutic Robot System (ETRS)

Current state of education and training for endoscopic submucosal dissection: Translating strategy and success to the USA

Intelligent Information-Guided Robotic Surgery

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