Post written by Xiuli Zuo, MD, PhD, from Qilu Hospital of Shandong University, Jinan, China.

The focus of my study includes medical mechatronics, balloon enteroscopy, inflammatory bowel diseases, and early GI cancer diagnosis and endoscopic treatment.

It is known that using a conventional endoscope to perform endoscopic submucosal dissection (ESD) is difficult because of the 1-handed manual operation. The poor vision of the submucosal plane and the limited dexterity of the traditional devices result in ESD being related to a high risk of bleeding and perforation and requiring long-term training. ESD has an urgent need for the modification of devices to facilitate the technical difficulty and improve the therapeutic outcome.

We developed a novel transendoscopic telerobotic system, a dual-arm robotic endoscopic assistant for minimally invasive surgery (DREAMS). The DREAMS system contained the current smallest robotic ESD instruments (with a diameter of 2.5 mm or 3.0 mm), and it was compatible with the commercially available flexible dual-channel endoscope.

The 2 robotic instruments of DREAMS can achieve safe collaboration and provide sufficient visualization and efficient dissection during ESD. The safety profile and technical feasibility of ESD were significantly improved with the assistance of the DREAMS system, especially in the narrower esophageal lumen.

The development of the medical robot has the potential to facilitate advanced endoscopic procedures such as ESD. The improvement of the endoscope used in the robotic system will be the next important task.

The DREAMS system. A, Appearance of DREAMS system prototype. B, Appearance of the flexible parallel continuum-based wrist (FPCW)-based instruments, showing the FPCW knife (right) and FPCW forceps (left). The rectangle indicates the FPCW structure. C, FPCW knife with 3 degrees of freedom. D, FPCW forceps with 5 degrees of freedom. DREAMS, Dual-arm robotic endoscopic assistant for minimally invasive surgery.

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