Robotic-assisted surgical endoscopy: a new era for endoluminal therapies

Abstract

Minimally invasive endoscopic procedures are associated with lower adverse events and shorter hospital stays compared with conventional open surgery. 1,2 However, some advanced endoscopic procedures, including endoscopic submucosal dissection (ESD), natural orifice transluminal endoscopic surgery (NOTES), and suturing, have typically required specialized training and a certain amount of experience to achieve competency. Therefore, these procedures are not widely performed in nonspecialized centers. 3-6 Despite the availability of a wide range of accessory devices, including distal attachment caps, electrosurgical knifes, hemostatic forceps, and suturing devices, the conventional flexible endoscopes used in clinical practice struggle to support the performance of advanced endosurgical procedures. They lack the dexterity required to perform useful maneuvers, such as triangulation of instruments and nonaxial tissue manipulation. Transmission of

Robotics and Artificial Intelligence in Gastrointestinal Endoscopy: Updated Review of the Literature and State of the Art

“…and force transmission to perform advanced procedures [1][2][3][4]. Moreover, techniques such as endoscopic submucosal dissection (ESD) are associated with long learning curves and an elevated rate of complications that limit their use to a restricted number of centers and operators [2,4].…”

“…and force transmission to perform advanced procedures [1][2][3][4]. Moreover, techniques such as endoscopic submucosal dissection (ESD) are associated with long learning curves and an elevated rate of complications that limit their use to a restricted number of centers and operators [2,4]. To overcome such limitations, several robots in endoscopy have been developed in the past decades, with the goal of improving the effectiveness, safety, and reliability of established procedures, as well as to expand the field of possible interventions [4].…”

Per-oral Endoscopic Myotomy and Other Applications of Third Space Endoscopy: Current Status and Future Perspectives

“…Robotic endoscopy has recently shown promising results even in endoscopic procedures like ZD and endoscopic submucosal dissection. [112][113][114][115] These robotic systems like the FLEX system from medrobotics have the combined features of the flexibility of endoscopes and strength of laparoscopic accessories with the capability of bimanual manipulation of the lesion with ease, however, currently, we have short length devices for hypopharyngeal and left colonic surgeries. 114 Moreover, the various prototype robot-driven endoscopic locomotion and instrument manipulation will shape the future of therapeutic endoscopy and TSE in particular.…”

“…Robotics have been increasingly used for pelvic dissections, urological procedures, and complex head surgeries since the last decade. Robotic endoscopy has recently shown promising results even in endoscopic procedures like ZD and endoscopic submucosal dissection 112–115. These robotic systems like the FLEX system from medrobotics have the combined features of the flexibility of endoscopes and strength of laparoscopic accessories with the capability of bimanual manipulation of the lesion with ease, however, currently, we have short length devices for hypopharyngeal and left colonic surgeries 114.…”

Compact Smartphone-Based Laser Speckle Contrast Imaging Endoscope Device for Point-of-Care Blood Flow Monitoring

“…Endoscopes are routinely used in diverse medical fields, such as gastroenterology, to visualize the hollow organ interiors of the body. The device enables intuitive examination [ 2 ], minimally invasive surgery [ 3 ], and treatment [ 4 ] at different cavity sites, which cannot be achieved by other diagnostic instruments. With the growing attention to personal healthcare services, the demand for an endoscope for point-of-care testing (POCT) has increased.…”