PDF(Pubmed)
Abstract：
Endoscopic submucosal dissection (ESD) is technically challenging and requires a high level of skill. However, there is no effective method of exposing the submucosal plane during dissection. In this study, the efficacy of robot arm-assisted tissue traction for gastric ESD was evaluated using an in vivo porcine model. The stomach of each pig was divided into eight locations. In the conventional ESD (C-ESD) group, one ESD was performed at each location (N = 8). In the robot arm-assisted ESD (R-ESD) group, two ESDs were performed at each location (N = 16). The primary endpoint was the submucosal dissection speed (mm2/s). The robot arm could apply tissue traction in the desired direction and successfully expose the submucosal plane during submucosal dissection in all lesion locations. The submucosal dissection speed was significantly faster in the R-ESD group than in the C-ESD group (p = 0.005). The blind dissection rate was significantly lower in the R-ESD group (P = 0.000). The robotic arm-assisted traction in ESD enabled a significant improvement in submucosal dissection speed, blind dissection rate which suggests the potential for making ESD easier and enhancing procedural efficiency and safety.
摘要：
内镜粘膜下剥离术（ESD）在技术上具有挑战性，需要高水平的技能。然而,在剥离过程中没有有效的方法暴露粘膜下平面。在这项研究中,使用体内猪模型评估了机器人手臂辅助组织牵引对胃ESD的疗效。每只猪的胃被分成八个位置。在常规ESD(C-ESD)组中,在每个位置执行一个ESD(N=8)。在机器人手臂辅助ESD(R-ESD)组中，在每个位置进行两次ESD(N=16)。主要终点是粘膜下剥离速度(mm2/s)。机器人臂可以在期望的方向上施加组织牵引,并且在所有病变位置中的粘膜下剥离期间成功地暴露粘膜下平面。R-ESD组粘膜下剥离速度明显快于C-ESD组(p=0.005)。R-ESD组的盲切率显著降低(P=0.000)。ESD中的机械臂辅助牵引使粘膜下剥离速度显着提高，盲目解剖率，这表明使ESD更容易，提高程序效率和安全性的潜力。
