Department of Surgery, Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Division of Gastroenterology, Department of Medicine, National University of Singapore, Singapore.
Gastrointest Endosc. 2021 May;93(5):1172-1177. doi: 10.1016/j.gie.2020.09.042. Epub 2020 Sep 28.
One of the difficulties in performing endoscopic submucosal dissection (ESD) is the lack of retraction during submucosal dissection. The development of the EndoMaster EASE System (EndoMaster Pte Ltd, Singapore) aims to enhance the safety and efficacy of ESD through 2 flexible robotic arms for tissue retraction and dissection. This is a preclinical animal study to evaluate the performance of colorectal ESD using the latest version of the EndoMaster EASE System.
The latest version of the EndoMaster EASE System consists of an independently designed, flexible platform with a built-in endoscopic imaging system and 3 working channels, 2 for the passage of robotic arms and 1 for accessories. In this animal study, the outcome measures were operating time (from starting incision to finishing dissection), completeness of resection, procedure-related adverse events, and limitations of arm manipulation in a narrow working space as assessed by counting the frequency of blind cutting.
Five ESD procedures were performed in a 66.7-kg porcine model with the animal under general anesthesia. The mean operative time was 73.8 minutes, and the mean size of the specimen resected was 1340 mm. There was no perforation, although profuse bleeding was encountered during 1 robotic ESD procedure.
The current preclinical study confirmed the feasibility of performing colorectal ESD using the latest version of the EndoMaster EASE System. The system was also tested for the ability to manage adverse events including bleeding and perforation. This study provided important preclinical experience for clinical trial.
内镜黏膜下剥离术（ESD）实施过程中的难点之一是黏膜下剥离时缺乏组织牵拉。EndoMaster EASE 系统（EndoMaster Pte Ltd，新加坡）的开发旨在通过 2 个用于组织牵拉和剥离的灵活机器人手臂来提高 ESD 的安全性和有效性。这是一项使用最新版 EndoMaster EASE 系统评估结直肠 ESD 性能的临床前动物研究。
最新版的 EndoMaster EASE 系统由一个独立设计的、带有内置内镜成像系统和 3 个工作通道的灵活平台组成，其中 2 个通道用于机器人手臂的通过，1 个通道用于附件。在这项动物研究中，评估指标包括操作时间（从开始切口到完成剥离）、切除的完整性、与手术相关的不良事件以及在狭窄工作空间中手臂操作的限制（通过计算盲目切割的频率来评估）。
在一只 66.7 公斤重的猪模型中进行了 5 例 ESD 手术，动物处于全身麻醉状态。平均手术时间为 73.8 分钟，切除标本的平均大小为 1340 毫米。虽然在 1 例机器人 ESD 手术中遇到了大量出血，但没有穿孔。
目前的临床前研究证实了使用最新版 EndoMaster EASE 系统进行结直肠 ESD 的可行性。该系统还测试了处理出血和穿孔等不良事件的能力。这项研究为临床试验提供了重要的临床前经验。
