A Soft Endorobot (SoftEn) for autonomous colonoscopy screening and treatment

结直肠癌（CRC）是全球第三大癌症死亡原因。2018年，全球报告了约180万例新病例，死亡率近90万。自2012年以来增长了30%以上。研究表明，定期筛查和早期发现可将死亡率降低高达70%。拟议的项目将进行跨学科研究，设计一种低成本、一次性、自主的软内机器人（SoftEn），以无痛地检查下肠道。SoftEn提供了替代当前光学结肠镜（OC）的颠覆性潜力，包括调查和执行自主手术任务的双重能力。SoftEn将克服OC的局限性（依赖操作员、患者疼痛/不适、高成本、净化）。最重要的是，高度的自主性将减少执行程序的时间，并将筛选过程从二级转移到中级或初级护理，从而节省诊断和干预的宝贵时间。通过减少执行手术所需的操作人员技能，将提高手术效率。这将增加每年进行的手术数量。2.减少等待名单将因此改善CRC的检测阶段，并将由于早期干预和降低治疗成本而提高患者的生存率。疼痛和不适减少将增加患者对筛选的可接受性以及患者体验。这有可能使镇静变得不必要，这反过来又会缩短住院时间。自主机器人检查大肠将消除传统的依赖操作员的OC的限制，并将使更多的访问调查。光学诊断和组织诊断可以在大多数手术中实现，包括需要更先进干预的患者。通过减少参与障碍，有可能提高筛查率。聚合物的使用意味着生产成本的降低，允许器械一次性使用，并避免传统OC所需的额外成本，包括灭菌和再处理。这将减少联合王国在CRC程序中的费用。人工智能软件将允许机器人自主执行程序。因此，临床医生可以监督多个设备，并仅在需要时通过外部人体工程学控制台进行本地或远程干预。这将限制临床医生的时间使用，并增加每天进行的调查数量。此外，更多的临床医生将能够执行支持国家内窥镜检查工作流程的程序。

Colorectal cancer (CRC) is the third cause of cancer death worldwide. In 2018, about 1.8 million new cases were reported worldwide with a mortality of almost 900,000. This has increased more than 30% since 2012. Studies have shown that regular screening and early detection can reduce mortality by up to 70%. The proposed project will undertake interdisciplinary research to design a low-cost, disposable, autonomous Soft Endorobot (SoftEn) to examine the lower intestine painlessly. SoftEn offers disruptive potential to replace the current optical colonoscopy (OC), including a dual capability of investigation and performance of autonomous surgical tasks. SoftEn will overcome OC's limitations (operator-dependent, patient pain/discomfort, high costs, decontamination). Crucially, the high level of autonomy will reduce the time in performing the procedure as well as shift screening process from secondary to intermediate or primary care, thus saving precious time for diagnosis and intervention.Advantages of this approach are:1. Efficiency of the procedure will be augmented by reducing the human-operator skills required to perform the procedure. This will increase the number of procedures performed every year.2. Reducing the waiting list will consequently improve the CRC stage of detection and will increase the patient survivability due to early intervention and reduced cost of treatment.3. Less pain and discomfort will increase the patient acceptability of the screening as well as patient experience. This has the potential to make sedation unnecessary, which in turn would make hospital visits shorter.4. Autonomous robot examination of the large intestine would remove restrictions of the traditional operator-dependent OC and would enable an increased access to investigation. Optical diagnosis and tissue diagnosis could be achieved in most of the procedures, including patients requiring more advanced intervention.5. Potentially improve screening uptake through reducing barriers to participation.6. The use of polymers implies a reduction in production costs, allowing the device to be single-use and avoiding additional costs required for a traditional OC, including sterilisation and reprocessing. This will reduce the UK cost in CRC procedures.7. AI software will allow the endorobot to perform procedures autonomously. A clinician can therefore supervise several devices and intervene only if needed via an external ergonomic control console, locally or remotely. This will limit the use of clinicians' time and increase the number of investigations performed per day. Additionally, more clinicians will be able to perform the procedure supporting the national endoscopy workflow.