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<p>Endoscopic Submucosal Dissection (ESD) is the gold standard for early gastrointestinal tumor resection but remains technically demanding due to limitations in visualization, traction, and instrument control. A flexible auxiliary single-arm transluminal endoscopic robot (FASTER, EndoFaster) was therefore developed to provide real-time traction assistance. The EndoFaster system underwent a two-stage validation. Technical assessment confirmed real-time control performance, including motion latency, trajectory fidelity, and positional accuracy. Subsequently, a prospective, randomized multicenter trial across six hospitals enrolled 192 ESD patients, randomized 1:1 to robotic-assisted ESD or conventional ESD. Primary endpoint was en bloc (R0) resection rate; secondary endpoints included dissection time, submucosal visualization, intraprocedural complications, and operator workload. EndoFaster achieved stable, accurate motion performance, systems validation confirmed precise real-time motion mapping between master–slave controllers within clinically acceptable thresholds. In multicenter clinical trials, en bloc resection rates were comparable between the EndoFaster (98.84%) and control groups (98.13%), confirming non-inferiority. The system significantly reduced dissection time (<i>P</i> = 0.00435), improved submucosal visualization, and decreased muscular injury incidence and operator workload. The EndoFaster robotic assistance system serves as a dynamic "third hand," effectively enhancing submucosal visualization and traction control. This improves the safety and efficiency of ESD while preserving standard clinical workflows.</p>

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A novel robotic system based on heterogeneous master–slave control algorithm: design and its clinical application in endoscopic submucosal dissection

  • 期刊论文

  • 发表日期：

    2025年9月19日

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  • Keshun Fan,
  • Miko Lin Lv,
  • Hongdong Tian,
  • Luping Shen,
  • Ang Ke,
  • Long Chen,
  • Huangtao Zhang,
  • Yuanming Jing,
  • Jialin Yang

摘要

Endoscopic Submucosal Dissection (ESD) is the gold standard for early gastrointestinal tumor resection but remains technically demanding due to limitations in visualization, traction, and instrument control. A flexible auxiliary single-arm transluminal endoscopic robot (FASTER, EndoFaster) was therefore developed to provide real-time traction assistance. The EndoFaster system underwent a two-stage validation. Technical assessment confirmed real-time control performance, including motion latency, trajectory fidelity, and positional accuracy. Subsequently, a prospective, randomized multicenter trial across six hospitals enrolled 192 ESD patients, randomized 1:1 to robotic-assisted ESD or conventional ESD. Primary endpoint was en bloc (R0) resection rate; secondary endpoints included dissection time, submucosal visualization, intraprocedural complications, and operator workload. EndoFaster achieved stable, accurate motion performance, systems validation confirmed precise real-time motion mapping between master–slave controllers within clinically acceptable thresholds. In multicenter clinical trials, en bloc resection rates were comparable between the EndoFaster (98.84%) and control groups (98.13%), confirming non-inferiority. The system significantly reduced dissection time (P = 0.00435), improved submucosal visualization, and decreased muscular injury incidence and operator workload. The EndoFaster robotic assistance system serves as a dynamic "third hand," effectively enhancing submucosal visualization and traction control. This improves the safety and efficiency of ESD while preserving standard clinical workflows.