講演情報
[ESY2-3]Flexible Endoscopic Robotic System
Simon Ng (Department of Surgery, The Chinese University of Hong Kong)
The recent progress in endoscopic technologies and interest in colorectal cancer screening have enabled the diagnosis of a larger number of early colorectal neoplasms. Most of these lesions are treated with laparoscopic resection. An alternative minimally invasive therapeutic option for these early lesions is endoscopic submucosal dissection (ESD). However, ESD is technically very challenging and carries a relatively high risk of complications. Furthermore, ESD has a very long learning curve.
To overcome these technical problems, people thought about the application of robotic technology. In order to perform endoluminal surgery such as colorectal ESD, the development of a flexible endoscopic robot that can travel along the colon is essential. A prototype endoscopic robot known as the Master And Slave Transluminal Endoscopic Robot (MASTER) was designed and built in 2006. In a preclinical study using ex vivo porcine stomach model, even non-clinician novices were able to successfully perform ESD using the prototype MASTER system, without any perforation. Endoscopy experts and non-experts could perform ESD much faster with the MASTER system.
The original prototype MASTER system was quite crude and bulky, with wires or exoskeleton mounted on a standard double-channel endoscope. With further technologic upgrades, a second-generation endoscopic robot, the EndoMaster EASE (Endoluminal Access Surgical Efficacy) System, was developed. The new system consists of an independently designed, flexible platform with a built-in endoscopic imaging system and three working channels, two for the passage of robotic arms and one for accessories. Recently, our research group at CUHK has completed the world's first clinical trial on robotic colorectal ESD (n = 43) using the EndoMaster EASE System. Our study has confirmed the safety and efficacy of this novel endoscopic robotic system. Further evaluation is needed before this system can be routinely used in clinical practice.
To overcome these technical problems, people thought about the application of robotic technology. In order to perform endoluminal surgery such as colorectal ESD, the development of a flexible endoscopic robot that can travel along the colon is essential. A prototype endoscopic robot known as the Master And Slave Transluminal Endoscopic Robot (MASTER) was designed and built in 2006. In a preclinical study using ex vivo porcine stomach model, even non-clinician novices were able to successfully perform ESD using the prototype MASTER system, without any perforation. Endoscopy experts and non-experts could perform ESD much faster with the MASTER system.
The original prototype MASTER system was quite crude and bulky, with wires or exoskeleton mounted on a standard double-channel endoscope. With further technologic upgrades, a second-generation endoscopic robot, the EndoMaster EASE (Endoluminal Access Surgical Efficacy) System, was developed. The new system consists of an independently designed, flexible platform with a built-in endoscopic imaging system and three working channels, two for the passage of robotic arms and one for accessories. Recently, our research group at CUHK has completed the world's first clinical trial on robotic colorectal ESD (n = 43) using the EndoMaster EASE System. Our study has confirmed the safety and efficacy of this novel endoscopic robotic system. Further evaluation is needed before this system can be routinely used in clinical practice.