RSS-Feed abonnieren
DOI: 10.1055/s-0032-1310251
Endoscopic submucosal dissection using the endoscopic operation robot
Publikationsverlauf
Publikationsdatum:
08. November 2012 (online)
![](https://www.thieme-connect.de/media/endoscopy/2012S02/lookinside/thumbnails/10.1055-s-0032-1310251-1.jpg)
Technological developments to minimize invasiveness are important for next-generation endoscopes; however, this should be a consistent standard during medical treatment. Thus, we have extended our focus and developed the endoscopic operation robot (EOR) to provide robotized operational support for flexible endoscopes, which can be complicated to manipulate [1]. The EOR enables distal manipulation by controlling the flexible endoscope in four axes – specifically, vertical (up – down) and horizontal angulation (left – right) using one joystick, and rotation, scope extension, and retraction using a second joystick. This report presents a further development, a unit capable of distal manipulation of insulated tip (IT) knife extension and retraction ([Fig. 1]), and knife tip insertion and withdrawal, which is fitted on the EOR to allow carrying out endoscopic submucosal dissection (ESD) ([ Fig. 2 ]). A third joystick controls the IT-knife extension and retraction in the vertical axis as well as the insertion and withdrawal of the knife tip in the horizontal axis ([Fig. 3]).
![](https://www.thieme-connect.de/media/endoscopy/2012S02/thumbnails/10-1055-s-0032-1310251-i367cl1.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
![](https://www.thieme-connect.de/media/endoscopy/2012S02/thumbnails/10-1055-s-0032-1310251-i367cl2.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
![](https://www.thieme-connect.de/media/endoscopy/2012S02/thumbnails/10-1055-s-0032-1310251-i367cl3.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
Three sections of a virtual lesion in a porcine resection model were resected using the EOR. As the present study focused on the specialized IT-knife unit, virtual lesion marking, localized submucosal injection of saline, initial incision, and virtual lesion recovery were carried out using conventional manual techniques. ESD was successfully achieved via distal manipulation. Excluding the manual techniques, the mean time required for EOR-mediated ESD of the three 30-mm virtual lesion sections was 16.5 minutes.
Devices such as a multitasking platform for endoscopic full-thickness resection have been developed for natural orifice transluminal endoscopic surgery (NOTES), and it is likely that such NOTES-related devices will be developed for a peroral endoscopic approach [2]. However, the EOR is specifically designed to ensure manipulability of the flexible endoscope in the next generation of endoscope treatment. The present study indicates that the EOR can be used for ESD.
-
References
- 1 Kume K, Kuroki T, Sugihara T et al. Development of a novel endoscopic manipulation system: The Endoscopic Operation Robot (EOR). World J Gastrointest Endosc 2011; 3: 145-150
- 2 Ikeda K, Sumiyama K, Tajiri H et al. Evaluation of a new multitasking platform for endoscopic full-thickness resection. Gastrointest Endosc 2011; 73: 117-122