Endoscopic submucosal dissection using a detachable assistant robot: a comparative in vivo feasibility study (with video)

Sang Hyun Kim, Byung Gon Kim, Hyuk Soon Choi, Daehie Hong, Se Hyun Jang, Kihun Hong, Jin Woo Choi, Seung Han Kim, Jae Min Lee, Eun-Sun Kim, Bora Keum, Yoon Tae Jeen, Hong Sik Lee, Hoon-Jai Chun

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Background: Appropriate tissue tension and clear visibility of the dissection area using traction are essential for effective and safe endoscopic submucosal dissection (ESD). We developed a robotic assistive traction device for flexible endoscopy and compared its safety and efficiency in ESD between experienced and novice endoscopists. Methods: Robotic ESD was performed by experienced and novice endoscopist groups (n = 2, each). The outcomes included time to complete each ESD step, total procedure time, size of the dissected mucosa, rate of en bloc resection, and major adverse events. Furthermore, incision and dissection speeds were compared between groups. Results: Sixteen gastric lesions were resected from nine live pigs. The submucosal incision speed was significantly faster in the expert group than in the novice group (P = 0.002). There was no significant difference in the submucosal dissection speed between the groups (P = 0.365). No complications were reported in either group. Conclusions: When the robot was assisting in the ESD procedure, the dissection speed improved significantly, especially in the novice surgeons. Our robotic device can provide simple, effective, and safe multidirectional traction during ESD.

Original languageEnglish
Pages (from-to)5836-5841
Number of pages6
JournalSurgical Endoscopy
Issue number10
Publication statusPublished - 2021 Oct

Bibliographical note

Funding Information:
This work was supported by the National Research Foundation of Korea (NRF) Grant funded by the Korea government (MSIT) (Grant No. NRF-2020R1A2C4002621). This study was supported by a Grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (Grant No. HI14C3477).

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.


  • Endoscopic submucosal dissection
  • Flexible endoscopy
  • Robot
  • Robotic-assisted flexible endoscope

ASJC Scopus subject areas

  • Surgery


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