Endoscopy 2018; 50(04): S98-S99
DOI: 10.1055/s-0038-1637320
ESGE Days 2018 oral presentations
21.04.2018 – Endoscopic submucosal dissection
Georg Thieme Verlag KG Stuttgart · New York

DEVELOPMENT AND FEASIBILITY STUDY OF KUMC ROBOTIC MANIPULATOR DURING ENDOSCOPIC SUBMUCOSAL DISSECTION

G Min
1   Korea University College of Medicine, seoul, Korea, Republic of
,
HS Choi
1   Korea University College of Medicine, seoul, Korea, Republic of
,
W Kim
1   Korea University College of Medicine, seoul, Korea, Republic of
,
SJ Choi
1   Korea University College of Medicine, seoul, Korea, Republic of
,
JM Lee
1   Korea University College of Medicine, seoul, Korea, Republic of
,
SH Kim
1   Korea University College of Medicine, seoul, Korea, Republic of
,
JM Lee
1   Korea University College of Medicine, seoul, Korea, Republic of
,
ES Kim
1   Korea University College of Medicine, seoul, Korea, Republic of
,
B Keum
1   Korea University College of Medicine, seoul, Korea, Republic of
,
YT Jeen
1   Korea University College of Medicine, seoul, Korea, Republic of
,
HS Lee
1   Korea University College of Medicine, seoul, Korea, Republic of
,
HJ Chun
1   Korea University College of Medicine, seoul, Korea, Republic of
,
CD Kim
1   Korea University College of Medicine, seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Gastrointestinal cancers are one of the most common malignancy worldwide. Especially endoscopic submucosal dissection (ESD) for early gastrointestinal cancers have been considered as the current standard cancer treatment. However, lack of counter traction during ESD procedure is one of major difficulty. To overcome this problem, we developed new endoscopic technique using robotic manipulator and conducted study about efficacy and safety in vitro animal study.

Methods:

A novel robotic suture manipulator is composed of control panel and a working arm, which grasp and move objects at the end of scope. A total of 10 porcine stomachs were used for the test. Porcine stomachs were assigned randomly to 2 groups and ESD was performed on mucosa of stomach using conventional technique and new endoscopic technique with robotic manipulator. Endoscopic experts and novice endoscopists performed ESD in 2 parts (antrum & body) of stomach. During procedure, robotic manipulator lifts up dissected tissue of stomach to make better visibility. Procedure time, complete resection rate, and complication such as perforation was recorded.

Results:

The average procedure time for the robotic manipulator and conventional ESD was 42 minutes and 45.9 minutes. In novice endoscopists, the average procedure time using robotic manipulator is faster than conventional ESD group (47.5 min vs. 55.3 min, p < 0.05). Both endoscopic expert and novice endoscopist completed the ESD procedure for en bloc resection of target lesions using KUMC robotic manipulator. There was no difference in complete resection rates between two groups. No complication such as perforation was occurred in both groups during the procedures. There was no difference depending on resected location in stomach.

Conclusions:

The robotic manipulator, which can perform ESD more easily showed feasible result comparing with conventional ESD. ESD using robotic manipulator could be helpful, especially in novice endoscopists. This research proposes a novel approach for safe and feasible method during ESD.