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

包括食道、胃和结肠在内的胃肠道癌症是全球十大癌症之一。与传统开放手术相比，早期胃肠道癌症和其他消化系统疾病的微创手术在减少创伤和更快的患者恢复方面具有重要优势。然而，当前内窥镜存在若干限制，包括远端力传递、器械三角测量、缺乏双手组织操纵和视觉空间定向。因此，介入性内窥镜检查需要相当多的经验，涉及复杂和耗时的工作流程。因此，由于结肠和小肠的曲折性质，相当数量的内窥镜介入无法到达结肠和小肠的末端。由于目前的COVID-19大流行，全国的内窥镜单位一直在努力进行胃肠道内窥镜检查，导致诊断和治疗延迟，影响患者发病率和死亡率。因此，改善柔性内窥镜的诊断和治疗，并促进其安全和经济的部署，应该是一个优先事项，是一个迫切的临床需求。这项研究旨在改变胃肠道的早期诊断和微创干预，包括小肠。为此，我们将开发必要的基础技术，以实现下一代软机器人内窥镜的自主自推进运动。脱离传统的推进式内窥镜检查范例将减少与早期诊断相关的不适，并将允许在二级或三级护理之外的治疗程序中不太熟练的内窥镜医生进行腔内和潜在的经腔手术。我们对可负担性的关注旨在解决传染病对一次性医疗设备日益增长的需求，并减少阻碍手术机器人在低收入国家广泛使用的财务障碍。

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.