630 Development of an Endoscopic Surgical Robotic System and From Bench to Animal Studies
Publication in refereed journal


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其它資訊
摘要Background
Endoscopic submucosal dissection (ESD) is established as a standard treatment for early gastrointestinal cancers with excellent outcomes. However, the techniques of ESD is difficult to master. The aim of this project is to develop a novel robotic system for performance of complex endoscopic procedures including ESD, with a translation of basic engineering technologies into clinical practice

Method
From 2014 to 2016 basing on a commercially available platform – the USGI Transport, we developed a prototype with 9-degree-of-freedoms (DOFs) robotic arms that has been shown to be successful in completing simpler surgical procedures such as tissue retraction. The system consisted of two robotic arms mounted with different end effectors for tissue retraction and dissection respectively. We developed an advanced and intelligent control scheme for intuitive manipulation of the robotic arms within the confined gastrointestinal lumen. Through the process of development, we have conducted multiple experiments using this prototype robotic endoscope for performance of ESD in ex-planted porcine stomach. After serval trials, we moved forward to conduct live porcine model experiment.

Results
From 2014 to 2016, a novel robotic endoscopic system was developed upon USGI transport. The two robotic arms could be retracted within the working channels during insertion of the transport into the porcine stomach. In the first ex-planted porcine stomach model, we successfully performed gastric ESD in size of 40mm using the robotic system. A total of four robotic ESDs were performed in ex-planted porcine model with an average specimen size of 35mm. The mean operative time was 35 minutes, and there was no perforation. Gastric ESD was performed in two live porcine models with our surgical robotic system (CU Robotic Endoscope) under general anesthesia. Figure 1 shows the experimental setup in the second trial. Figure 2 shows a typical endoscopic view during this trial. The mean operative time was 50 minutes, and the mean size of specimen was 30mm. There was no perforation or intraprocedural bleeding, and the speed of dissection per specimen area was 1.9mm2/minutes. The efficiency of the robotic system, especially in dissection, surpass the ordinary ESD procedure, mainly due to strong tissue retraction ability of the robotic system. This prevented the target area being blocked by the dissected tissue which increase the difficulties of dissection.

Conclusion
Our study confirmed the efficacy and safety of a newly designed robotic endoscope building on USGI Transport for performance of gastric ESD. Future prospective clinical study will focus on performance of gastric and rectal ESD using this system.
著者Kachun Lau, Yun Yee Leung, Carmen Poon, Yeung Yam, James Y. Lau, Philip Wai Yan W. Chiu
期刊名稱Gastrointestinal Endoscopy
出版年份2017
月份5
卷號85
期次5 Supplement
出版社Elsevier
頁次AB90 - AB91
國際標準期刊號0016-5107
電子國際標準期刊號1097-6779
語言美式英語

上次更新時間 2020-29-10 於 01:43