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Surgical Endoscopy

, Volume 32, Issue 7, pp 3386–3392 | Cite as

A new robotic-assisted flexible endoscope with single-hand control: endoscopic submucosal dissection in the ex vivo porcine stomach

  • Tsutomu Iwasa
  • Ryu Nakadate
  • Shinya Onogi
  • Yasuharu Okamoto
  • Jumpei Arata
  • Susumu Oguri
  • Haruei Ogino
  • Eikichi Ihara
  • Kenoki Ohuchida
  • Tomohiko Akahoshi
  • Tetsuo Ikeda
  • Yoshihiro Ogawa
  • Makoto Hashizume
Dynamic Manuscript
  • 239 Downloads

Abstract

Background

Difficulties in endoscopic operations and therapeutic procedures seem to occur due to the complexity of operating the endoscope dial as well as difficulty in performing synchronized movements with both hands. We developed a prototype robotic-assisted flexible endoscope that can be controlled with a single hand in order to simplify the operation of the endoscope. The aim of this study was to confirm the operability of the robotic-assisted flexible endoscope (RAFE) by performing endoscopic submucosal dissection (ESD).

Methods

Study 1: ESD was performed manually or with RAFE by an expert endoscopist in ex vivo porcine stomachs; six operations manually and six were performed with RAFE. The procedure time per unit circumferential length/area was calculated, and the results were statistically analyzed. Study 2: We evaluated how smoothly a non-endoscopist can move a RAFE compared to a manual endoscope by assessing the designated movement of the endoscope.

Results

Study 1: En bloc resection was achieved by ESD using the RAFE. The procedure time was gradually shortened with increasing experience, and the procedure time of ESD performed with the RAFE was not significantly different from that of ESD performed with a manual endoscope. Study 2: The time for the designated movement of the endoscope was significantly shorter with a RAFE than that with a manual endoscope as for a non-endoscopist.

Conclusions

The RAFE that we developed enabled an expert endoscopist to perform the ESD procedure without any problems and allowed a non-endoscopist to control the endoscope more easily and quickly than a manual endoscope. The RAFE is expected to undergo further development.

Keywords

Flexible endoscopy Robotic-assisted flexible endoscope Endoscopic submucosal dissection Laparoscopic surgery Natural orifice transluminal endoscopic surgery 

Notes

Compliance with ethical standards

Disclosures

Tsutomu Iwasa, Ryu Nakadate, Shinya Onogi, Yasuharu Okamoto, Jumpei Arata, Susumu Oguri, Haruei Ogino, Eikichi Ihara, Kenoki Ohuchida, Tomohiko Akahoshi, Tetsuo Ikeda, Yoshihiro Ogawa, and Makoto Hashizume have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (MP4 20981 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Tsutomu Iwasa
    • 1
    • 2
    • 6
  • Ryu Nakadate
    • 3
  • Shinya Onogi
    • 1
  • Yasuharu Okamoto
    • 4
  • Jumpei Arata
    • 5
  • Susumu Oguri
    • 6
  • Haruei Ogino
    • 2
  • Eikichi Ihara
    • 2
  • Kenoki Ohuchida
    • 7
  • Tomohiko Akahoshi
    • 6
  • Tetsuo Ikeda
    • 6
  • Yoshihiro Ogawa
    • 2
  • Makoto Hashizume
    • 1
    • 3
    • 6
  1. 1.Division of Minimally Invasive Advanced Medical Science, Center for Advanced Medical InnovationKyushu UniversityFukuokaJapan
  2. 2.Department of Medicine and Bioregulatory Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  3. 3.Division of Research Project, Center for Advanced Medical InnovationKyushu UniversityFukuokaJapan
  4. 4.Department of Medicine and Clinical Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  5. 5.Department of Mechanical Engineering, Faculty of EngineeringKyushu UniversityFukuokaJapan
  6. 6.Department of Advanced Medical Initiatives, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  7. 7.Department of Surgery and Oncology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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