We are pleased to announce Professor Philip Chiu, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, is one of the featured speakers of the Hamlyn Symposium on Medical Robotics 2021 (#HSMR21).
Professor Chiu gave a talk on ‘Flexible endoscopic robot for treatment of gastrointestinal cancers – from bench to clinical application’ followed by a Q&A session.
Gastrointestinal cancers are the commonest cancer worldwide, and the treatment outcome correlates with stage of cancer diagnosis. With introduction of screening endoscopy, AI and image enhanced endoscopy, gastrointestinal cancers should be diagnosed at early stage. Endoscopic submucosal dissection (ESD) is currently established as treatment of early-stage gastrointestinal cancer with high rate of en-bloc resection. However, ESD is technically demanding with significant risks of bleeding and perforation. One of the major limitations in performing ESD is due to the technical design of dissection knife passing through the working channel which is in co-axial direction with the endoscope.
The development of flexible robotics allowed increased degree of freedom for therapeutic instruments deep within the gastrointestinal tract. In collaboration with National University of Singapore and Nanyang Technological University, we developed the Master and Slave Transluminal Endoscopic Robot (MASTER) . The first prototype of EndoMaster was tested in a clinical proof of concept study with 5 patients receiving robotic ESD for treatment of early gastric cancers. All patients received successful ESD procedure with no complication. The system was further developed into the new generation of EndoMaster EASE system. We conducted preclinical studies on use of EndoMaster EASE system for performance of robotic ESD in esophagus and colon [2,3,4]. The results demonstrated success in performance of ESD using EndoMaster EASE system in esophagus and colorectum. With the encouraging results from preclinical studies, our team started clinical trial for performance of colorectal ESD in treatment of early colorectal neoplasia.
The other direction in development of flexible robotics is to design novel flexible robotic arms for dissection and retraction building on existing endoscopic platform. Our team of engineers and clinicians from Chinese University of Hong Kong adopting a different design mechanism and developed flexible robotic system for performance of gastric ESD .
In future, flexible robotics will be increasingly applied for development of therapeutic devices including suturing and stapling devices for treatment of gastrointestinal diseases .
1. . Robot-assisted endoscopic submucosal dissection is effective in treating patients with early-stage gastric neoplasia. Phee SJ, Reddy N, Chiu PW, Rebala P, Rao GV, Wang Z, Sun Z, Wong JY, Ho KY. Clin Gastroenterol Hepatol. 2012 Oct;10(10):1117-21.
2. Enhancing proficiency in performing endoscopic submucosal dissection (ESD) by using a prototype robotic endoscope. Chiu PW, Phee SJ, Bhandari P, Sumiyama K, Ohya T, Wong J, Poon CC, Tajiri H, Nakajima K, Ho KY. Endosc Int Open. 2015 Oct;3(5):E439-42.
3. Feasibility of performing esophageal endoscopic submucosal dissection using master and slave transluminal endoscopic robot. Takeshita N, Ho KY, Phee SJ, Wong J, Chiu PW. Endoscopy. 2017 Feb;49(S 01):E27-E28.
4. Colonic endoscopic submucosal dissection using a novel robotic system (with video). Chiu PWY, Ho KY, Phee SJ. Gastrointest Endosc. 2021 May;93(5):1172-1177.
5. A flexible surgical robotic system for removal of early-stage gastrointestinal cancers by endoscopic submucosal dissection KC Lau, EYY Leung, PWY Chiu, Y Yam, JYW Lau, CCY Poon. IEEE Transactions on Industrial Informatics 2016; 12 (6), 2365-2374
6. Application of robotics in gastrointestinal endoscopy: A review. Yeung BP, Chiu PW. World J Gastroenterol. 2016 Feb 7;22(5):1811-25.