Self-propelled soft robotic endoscopes for next-generation gastrointestinal surgery (ROBOGAST)

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Gastrointestinal cancers, including oesophagus, stomach and colon, are among the top ten cancers worldwide. Minimally invasive surgery of early gastrointestinal cancer and other digestive diseases offer important advantages compared to traditional open surgery in terms of reduced trauma and faster patient recovery. However, there are several limitations to current endoscopes including distal force transmission, triangulation of instruments, lack of bimanual tissue manipulations and visual-spatial orientation. Thus interventional endoscopy requires considerable experience and involves complex and time-consuming workflows. As a result, a sizeable amount of endoscopic interventions fail to reach the end of the colon and the small intestine because of their tortuous nature. Due to the current COVID-19 pandemic, endoscopy units nationwide have been struggling with capacity to perform gastrointestinal endoscopies resulting in a delay to diagnosis and treatment, impacting patient morbidity and mortality. Improving access to flexible endoscopy for diagnosis and treatment, and facilitating its deployment safely and affordably, should therefore be a priority and is a pressing clinical need.This research aims to transform early diagnosis and minimally invasive intervention of the gastrointestinal tract, including the small intestine. To this end we will develop the underlying technology necessary to achieve autonomous self-propelled locomotion for the next generation of soft robotic endoscopes. Departing from the conventional push-endoscopy paradigm will reduce the discomfort associated to early diagnosis and will allow endoscopists who are less skilled in therapeutic procedures, outside secondary or tertiary care, to perform endoluminal and potentially transluminal surgery. Our focus on affordability aims to address the growing demand for single-use medical devices driven by infectious diseases, and to reduce the financial barriers that are preventing the wider use of surgical robotics in low-income countries.