A Novel Retractable Robotic Device for Esophageal Endoscopic Submucosal Dissection

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Aims Endoscopic submucosal dissection (ESD) is an effective treatment for gastrointestinal tumors but poses significant technical challenges, including lengthy operation times and a high risk of complications. To address these challenges in ESD, numerous ESD tissue traction techniques have been developed. This study aims to evaluate the feasibility and safety of a novel robotic traction device for ESD tissue traction in esophageal ESD. Methods An experienced endoscopist performed ESD 8 times on an in vivo porcine esophagus using the robot and 8 times using the conventional method. The outcome measures were procedure time, dissection speed, procedure-related adverse events, and blind dissection rate. Results A total of sixteen esophageal lesions were resected from in vivo pigs. The use of the robotic system (RESD) resulted in a significantly reduced total procedure time (20.1±4.1 minutes) compared to conventional ESD (CESD) (34.3±8.3 minutes, p<0.05). RESD also achieved a faster submucosal dissection speed (36.8±9.2 mm²/min versus 18.1±4.7 mm²/min, p<0.05) and a lower blind dissection rate (12.8%±3.4% versus 35.1%±3.9%, p<0.05). Conclusions The dissection speed and safety profile improved significantly with the RESD. Thus, our robotic device has the potential to provide simple, effective, and safe multidirectional traction during esophageal ESD. Publication History Article published online: 27 March 2025 © 2025. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

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