Sang Hyun Kim, Chanwoo Kim, Bora Keum, Junghyun Im, Seonghyeon Won, Byung Gon Kim, Kyungnam Kim, Taebin Kwon, Daehie Hong, Han Jo Jeon, Hyuk Soon Choi, Eun Sun Kim, Yoon Tae Jeen, Hoon Jai Chun, Joo Ha Hwang
{"title":"用于结直肠内镜黏膜下剥离术的新型可伸缩机器人设备","authors":"Sang Hyun Kim, Chanwoo Kim, Bora Keum, Junghyun Im, Seonghyeon Won, Byung Gon Kim, Kyungnam Kim, Taebin Kwon, Daehie Hong, Han Jo Jeon, Hyuk Soon Choi, Eun Sun Kim, Yoon Tae Jeen, Hoon Jai Chun, Joo Ha Hwang","doi":"10.5009/gnl230280","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aims: </strong>: Appropriate tissue tension and clear visibility of the dissection area using traction are essential for effective and safe endoscopic submucosal dissection (ESD). In this study, we developed a retractable robot-assisted traction device and evaluated its performance in colorectal ESD.</p><p><strong>Methods: </strong>: An experienced endoscopist performed ESD 18 times on an <i>ex vivo</i> porcine colon using the robot and 18 times using the conventional method. The outcome measures were procedure time, dissection speed, procedure-related adverse events, and blind dissection rate.</p><p><strong>Results: </strong>: Thirty-six colonic lesions were resected from <i>ex vivo</i> porcine colon samples. The total procedure time was significantly shorter in robot-assisted ESD (RESD) than in conventional ESD (CESD) (20.1±4.1 minutes vs 34.3±8.3 minutes, p<0.05). The submucosal dissection speed was significantly faster in the RESD group than in the CESD group (36.8±9.2 mm<sup>2</sup>/min vs 18.1±4.7 mm<sup>2</sup>/min, p<0.05). The blind dissection rate was also significantly lower in the RESD group (12.8%±3.4% vs 35.1%±3.9%, p<0.05). In an <i>in vivo</i> porcine feasibility study, the robotic device was attached to a colonoscope and successfully inserted into the proximal colon without damaging the colonic wall, and ESD was successfully performed.</p><p><strong>Conclusions: </strong>: The dissection speed and safety profile improved significantly with the retractable RESD. Thus, our robotic device has the potential to provide simple, effective, and safe multidirectional traction during colonic ESD.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"677-685"},"PeriodicalIF":3.4000,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249931/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Novel Retractable Robotic Device for Colorectal Endoscopic Submucosal Dissection.\",\"authors\":\"Sang Hyun Kim, Chanwoo Kim, Bora Keum, Junghyun Im, Seonghyeon Won, Byung Gon Kim, Kyungnam Kim, Taebin Kwon, Daehie Hong, Han Jo Jeon, Hyuk Soon Choi, Eun Sun Kim, Yoon Tae Jeen, Hoon Jai Chun, Joo Ha Hwang\",\"doi\":\"10.5009/gnl230280\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aims: </strong>: Appropriate tissue tension and clear visibility of the dissection area using traction are essential for effective and safe endoscopic submucosal dissection (ESD). 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In an <i>in vivo</i> porcine feasibility study, the robotic device was attached to a colonoscope and successfully inserted into the proximal colon without damaging the colonic wall, and ESD was successfully performed.</p><p><strong>Conclusions: </strong>: The dissection speed and safety profile improved significantly with the retractable RESD. 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引用次数: 0
摘要
背景/目的利用牵引力获得适当的组织张力和清晰可见的解剖区域对于有效和安全地进行内镜粘膜下剥离(ESD)至关重要。在这项研究中,我们开发了一种可伸缩的机器人辅助牵引装置,并对其在结直肠ESD中的性能进行了评估:一名经验丰富的内镜医师使用机器人和传统方法分别对猪结肠进行了18次ESD操作。结果: :从活体猪结肠样本中切除了 36 个结肠病灶。机器人辅助ESD(RESD)的总手术时间明显短于传统ESD(CESD)(20.1±4.1分钟 vs 34.3±8.3分钟,p2/min vs 18.1±4.7 mm2/min):结论:使用可伸缩式 RESD 后,解剖速度和安全性显著提高。因此,我们的机器人设备有望在结肠ESD过程中提供简单、有效和安全的多向牵引。
A Novel Retractable Robotic Device for Colorectal Endoscopic Submucosal Dissection.
Background/aims: : Appropriate tissue tension and clear visibility of the dissection area using traction are essential for effective and safe endoscopic submucosal dissection (ESD). In this study, we developed a retractable robot-assisted traction device and evaluated its performance in colorectal ESD.
Methods: : An experienced endoscopist performed ESD 18 times on an ex vivo porcine colon using the robot and 18 times using the conventional method. The outcome measures were procedure time, dissection speed, procedure-related adverse events, and blind dissection rate.
Results: : Thirty-six colonic lesions were resected from ex vivo porcine colon samples. The total procedure time was significantly shorter in robot-assisted ESD (RESD) than in conventional ESD (CESD) (20.1±4.1 minutes vs 34.3±8.3 minutes, p<0.05). The submucosal dissection speed was significantly faster in the RESD group than in the CESD group (36.8±9.2 mm2/min vs 18.1±4.7 mm2/min, p<0.05). The blind dissection rate was also significantly lower in the RESD group (12.8%±3.4% vs 35.1%±3.9%, p<0.05). In an in vivo porcine feasibility study, the robotic device was attached to a colonoscope and successfully inserted into the proximal colon without damaging the colonic wall, and ESD was successfully performed.
Conclusions: : The dissection speed and safety profile improved significantly with the retractable RESD. Thus, our robotic device has the potential to provide simple, effective, and safe multidirectional traction during colonic ESD.
期刊介绍:
Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut and Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology.
Gut and Liver is jointly owned and operated by 8 affiliated societies in the field of gastroenterology, namely: the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, the Korean Pancreatobiliary Association, and the Korean Society of Gastrointestinal Cancer.