An advanced endoscopic surgery robotic platform for removal of early-stage gastrointestinal cancer using endoscopic submucosal dissection

Abstract

Two gastrointestinal (GI) cancers, stomach and colorectal cancer, have the fifth and third highest incident rates and the fourth and second highest mortality rates among all cancers, respectively. Combined, they had 2.8 million new cases and 1.6 million deaths annually. Fortunately, early-stage GI cancer has a high five-year survival rate if the tumour can be removed completely. Endoscopic Submucosal Dissection (ESD) is the gold standard for the removal of early-stage GI cancer as it has a high rate of en-bloc resection and a low rate of recurrence. However, ESD is a very technically challenging surgical operation. It has a relatively high rate of failure, including perforation of the stomach or colon. Therefore, a surgical robotic platform with high dexterity and better ergonomics is in high demand, which can ease the technical problems induced by conventional ESD procedures. In our previous study, a prototype of an endoscopic surgery robotic platform was built and the preliminary experimental results showed that the dual flexible arm robotic platform with wire-driven continuum structure was capable of increasing the efficiency and safety in performing ESD under the master-slave controlling scheme. An advanced robotic platform was built based on this prototype to achieve higher flexibility and production requirements. The design of these two platforms and experimental results will be presented in detail.