Endoscopic submucosal dissection using the endoscopic operation robot

Abstract

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]).