ESD CYCLOPS: A New Robotic Surgical System for GI Surgery

Abstract

Gastrointestinal (GI) cancers account for 1.5 million deaths worldwide. Endoscopic Submucosal Dissection (ESD) is an advanced therapeutic endoscopy technique with superior clinical outcome due to the minimally invasive and en bloc removal of tumours. In the western world, ESD is seldom carried out, due to its complex and challenging nature. Various surgical systems are being developed to make this therapy accessible, however, these solutions have shown limited operational workspace, dexterity, or low force exertion capabilities. The current paper shows the ESD CYCLOPS system, a bimanual surgical robotic attachment that can be mounted at the end of any flexible endoscope. The system is able to achieve forces of up to 46N, and showed a mean error of 0.217mm during an elliptical tracing task. The workspace and instrument dexterity is shown by pre-clinical ex vivo trials, in which ESD is succesfully performed by a GI surgeon. The system is currently undergoing pre-clinical in vivo validation.

Soft Robotics in Minimally Invasive Surgery

“…Soft robotic devices for minimally invasive procedures should therefore also aim to provide both diagnostic and therapeutic capabilities. The advantages of traditional endoscopes can be expanded upon and the therapeutic capabilities improved by attaching deployable structures to the endoscope tip, such as the inflatable structure in Vrielink et al ., 86 which supports two cable-driven surgical instruments for intuitive, bimanual control.…”

K‐FLEX: A flexible robotic platform for scar‐free endoscopic surgery

“…It is noteworthy that MASTER and CYCLOPS have presented higher payload capabilities (3 N and 7.5 N, respectively) with their novel design of surgical arms. However, their overall dimensions have been highly increased consequently (22 mm and 18 × 30 mm, respectively), which are considered as insufficient miniaturization for gastric insertion.…”

“…The identified examples include MASTER and i2Snake . Some platforms including EndoSAMURAI, Cobra, and CYCLOPS provide an internal channel inside each steerable branch to allow for exchange of standard surgical instruments. The internal channel also enables the surgical tip to move forward from the steerable branches, creating a large workspace to grasp tissue.…”

“…Robotic technologies have overcome the limitations of these manual platforms facilitating intuitive and efficient multitasking control on the surgeon's side as well as the precise and intelligent movement of the robot on the patient's side. STRAS, MASTER, ViaCath, FLEX, i2Snake, and CYCLOPS systems have shown the possibility of advanced endoscopic surgery with their highly dexterous robotic arm. However, they also seem to have common difficulties in designing flexible manipulators with sufficient miniaturization and payload capability to perform various intraluminal surgical operations.…”

LaryngoTORS: A Novel Cable-Driven Parallel Robotic System for Transoral Laser Phonosurgery

“…High force transmission, relatively large workspace, rapid deployability and low cost are some of the intrinsic advantages of such mechanisms. The ESD CYCLOPS is a CDPM robotic system currently undergoing pre-clinical validation in advanced GI surgery techniques [20], [21]. Unlike serial mechanisms, parallel approaches do not suffer from errors accumulating through the kinematic chain and thus could provide accurate and repeatable control of an end-effector accommodating a laser fiber.…”