A pilot study of endoscopic submucosal dissection using an endoscopic assistive robot in a porcine stomach model

Byung Gon Kim, Hyuk Soon Choi, Sei Hoon Park, Jun Ho Hong, Jung Min Lee, Seung Han Kim, Hoon Jai Chun, Daehie Hong, Bora Keum

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)


Background/Aims: Endoscopic assistive devices have been developed to reduce the complexity and improve the safety of surgeries involving the use of endoscopes. We developed an assistive robotic arm for endoscopic submucosal dissection (ESD) and evaluated its efficiency and safety in this in vitro pilot study. Methods: ESD was performed using an auxiliary transluminal endoscopic robot. An in vitro test bed replicating the intra-abdominal environment and pig stomachs were used for the experiment. Participants were divided into skilled operators and unskilled operators. Each group performed ESD 10 times by using both conventional and robot-assisted methods. The perforation incidence, operation time, and resected mucous membrane size were measured. Results: For the conventional method, significant differences were noted between skilled and unskilled operators regarding operation time (11.3 minutes vs 26.7 minutes) and perforation incidence (0/10 vs 6/10). Unskilled operators showed a large decrease in the perforation incidence with the robot-assisted method (conventional method vs robot-assisted method, 6/10 vs 1/10). However, the operation time did not differ between the conventional and robotassisted methods. On the other hand, skilled operators did not show differences in the operation time and perforation incidence between the conventional and robot-assisted methods. Among both skilled and unskilled operators, the operation time decreased with the robot-assisted method as the experiment proceeded. Conclusions: The surgical safety of unskilled operators greatly improved with robotic assistance. Thus, our assistive robotic arm was beneficial for ESD. Our findings suggest that endoscopic assistive robots have positive effects on surgical safety.

Original languageEnglish
Pages (from-to)402-408
Number of pages7
JournalGut and liver
Issue number4
Publication statusPublished - 2019

Bibliographical note

Publisher Copyright:
© 2019 Editorial Office of Gut and Liver. All rights reserved.


  • Computer-assisted
  • Endoscopic mucosal resection
  • Endoscopy
  • Pilot projects
  • Surgery

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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