A Feasibility Study of Unconstrained Robotic Traction Device for Endoscopic Submucosal Dissection
Refereed conference paper presented and published in conference proceedings

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AbstractEndoscopic Submucosal Dissection (ESD) is an emerging endoscopic technique for the removal of large lesion en- bloc with low rate of recurrence. However, lack of traction-contraction is the main challenge that prolongs the time
for operation, steepens the learning curve, and increases the risk of complications. Some traction assisting methods, including magnetic anchor and clip-and-string are cost-effective and efficient in increasing exposure of the submucosal surgical field, but only unidirectional retraction of resected mucosa can be achieved. Secondary hand methods, including the use of external forceps, double-balloon, and robotic-assisted system are more tolerant to lift the tissue but suffering from coupled movement between the lifter and the dissector. Recent bimanual endoscopic robots prompt to provide an optimal solution but the long development time and large investment involved hinder the readily applicability of these complex systems. Methods: We propose a robotic traction device (RTD) consisting of a
passive bending section, a flexible robotic lifter, an actuation unit, and a single-hand controller. The passive bending overtube is customizable for most commercial endoscopes in various diameters and lengths with an over-the-scope accessory channel for the robotic lifter. Dexterous tissue manipulation is achieved by the 4-Degree-ofFreedom (DoF) robotic lifter, where the 2-DoF bending allows up-down and leftright traction directions, the translation allows push and pull of the grasper to adjust the distance from the tip of the endoscope to the dissected site, and the open-close
motion allows relocation of the grasper. Decoupled motion between the robotic lifter and the endoscope is achieved by the distally mounted overtube which partially constrained the bending section of the endoscope, resulting the unconstrained part of the endoscope to move pseudo-independently from the robotic lifter. During RTD-assisted ESD procedures, a stable view to a well- exposed submucosa can be achieved with minimal interference from the dissections.
All Author(s) ListF. F. Leung, C. P. Lam, L. W. Cheung, D. N. F. Lai, Y. Yam, Philip W. Y. Chiu, K. C. Lau
Name of ConferenceDigestive Disease Week 2022
Start Date of Conference21/05/2022
End Date of Conference24/05/2022
Place of ConferenceSan Diego
Country/Region of ConferenceUnited States of America
Volume Number95
Issue NumberSuppl. 6
PagesAB442 - AB443
LanguagesEnglish-United Kingdom

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