Yan B, Liu H, Yang Y S, Yang Y M, Peng L H, Pan F, Jiang W, Yu T, Zhou Y Y, He X, Wang L, Li J F, Wang X X, Zhang X L, Wang Z K, Wang S F, Shi Y C, Wang W F, Yang J, Wang X D
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China.
Zhonghua Nei Ke Za Zhi. 2018 Dec 1;57(12):901-906. doi: 10.3760/cma.j.issn.0578-1426.2018.12.005.
To evaluate the feasibility and safety of the robot-assisted system YunSRobot for remote manipulation endoscopy. When the master of YunSRobot was installed in the gastroenterology office in Chinese PLA General Hospital, the robot slave and upper gastrointestinal simulation model (Takahashi Lm103, Japan) were installed at the same time in the State Key Laboratory of Robotics, Shenyang Institute of Automation. Three physicians were trained to operate the master robotics and performed gastroscopy on the simulation model based on network cloud. Each physician performed 3 procedures of oesophagogastroduodenoscopy (EGD) by YunSRobot using traditional manual endoscopy, on-site operating mode, and remote manipulation mode, respectively. The operating time, lumenal anatomic exposure, man-machine interaction and other parameters were recorded. The number of standard pictures obtained by traditional manual endoscopy group, on-site operating group and remote manipulation group were 39.9±0.3, 39.8±0.4, 39.9±0.3, respectively. The images of all five lesions could be obtained by each operation. The operating time in the duodenum of remote group was longer than that of on-site group, with average time (78.2±16.0)s vs. (68.9±15.8)s (0.021) respectively. As to the operating time on other parts or total time, all three groups were comparable. Although there was a mean delay of (572.1±48.5) ms in remote operation group, the operation was still smooth. However, compared with on-site group, the percentage of clear view time in the duodenum was significantly shortened in remote group: [(77.8±8.2)% vs. (83.9±6.4)%, 0.024]. Statistically significant difference was detected in percentage of clear view time neither in other sites, nor was in the total operating time between two groups. The operating time in each part of remote group was obviously longer than that of manual group as followings, pharyngeal (27.3±4.2) s vs. (9.2±1.3)s (0.001), esophageal (29.7±6.4)s vs. (19.3±1.6)s (0.004), stomach (56.7±17.0)s vs. (40.3±7.0)s (0.003), pylorus (20.2±5.5)s vs. (9.3±1.3)s (0.001), duodenum (78.2±16.0)s vs. (29.3±5.6)s (0.001). Thus the total operating time was also longer in remote group as (559.0±87.2)s vs. (253.1±16.6)s (0.001). The respective time in pharynx, esophagus, stomach, pylorus, duodenum, or the overall time was all longer in remote group than that in manual group. The soft endoscopy robot YunSRobot has satisfactory safety and stability. Remote upper gastrointestinal endoscopy can be completed based on common network and an endoscope simulation model with smooth operation. The inspection time by YunSRobot robot per part and the overall time are longer than those of manual operation on site, still, remote operating time meets the standard of upper gastrointestinal endoscopy.
评估机器人辅助系统YunSRobot用于远程操作内镜检查的可行性和安全性。将YunSRobot的主端安装在中国人民解放军总医院的消化内科办公室，同时将机器人从端和上消化道模拟模型（日本高桥Lm103）安装在沈阳自动化研究所机器人学国家重点实验室。对三名医生进行培训以操作主机器人，并基于网络云在模拟模型上进行胃镜检查。每位医生分别使用传统手动内镜、现场操作模式和远程操作模式，通过YunSRobot进行3次食管胃十二指肠镜检查（EGD）操作。记录操作时间、管腔解剖暴露情况、人机交互等参数。传统手动内镜组、现场操作组和远程操作组获得的标准图片数量分别为39.9±0.3、39.8±0.4、39.9±0.3。每次操作均能获取所有五个病变的图像。远程组在十二指肠的操作时间长于现场组，平均时间分别为（78.2±16.0）秒和（68.9±15.8）秒（P = 0.021）。至于其他部位的操作时间或总时间，三组相当。虽然远程操作组平均有（572.1±48.5）毫秒的延迟，但操作仍很顺畅。然而，与现场组相比，远程组在十二指肠的清晰视野时间百分比显著缩短：[（77.8±8.2）%对（83.9±6.4）%，P = 0.024]。两组在其他部位的清晰视野时间百分比以及总操作时间方面均未检测到统计学显著差异。远程组各部位的操作时间明显长于手动组，如下所示，咽部（27.3±4.2）秒对（9.2±1.3）秒（P = 0.001），食管（29.7±6.4）秒对（19.3±1.6）秒（P = 0.004），胃（56.7±17.0）秒对（40.3±7.0）秒（P = 0.003），幽门（20.2±5.5）秒对（9.3±1.3）秒（P = 0.001），十二指肠（78.2±16.0）秒对（29.3±5.6）秒（P = 0.001）。因此，远程组的总操作时间也更长，为（559.0±87.2）秒对（253.1±16.6）秒（P = 0.001）。远程组在咽部、食管、胃、幽门、十二指肠的各自时间或总体时间均长于手动组。软性内镜机器人YunSRobot具有令人满意的安全性和稳定性。基于普通网络和内镜模拟模型可以完成远程上消化道内镜检查，操作顺畅。YunSRobot机器人检查每个部位的时间和总时间长于现场手动操作，但远程操作时间仍符合上消化道内镜检查的标准。
