Safety of ROBOPERA as a Traction Device for Enhancing Submucosal Exposure during Gastric Endoscopic Submucosal Dissection: Prospective, Single-Arm, Pilot Study.

Background/Aims Endoscopic submucosal dissection (ESD) is gaining popularity as the procedure of choice for managing early upper gastrointestinal cancers. To overcome the obstacle of inadequate retraction, various traction systems have been described in the literature. The ROBOPERA (ENDOROBOTICS, Korea, Seoul) is a dedicated retraction device for ESD that has recently become commercially available. Methods This was a prospective clinical comparative study conducted between May 2024 and September 2024 in the Korea University Anam Hospital. Consecutive ESDs were performed by four experienced endoscopists in the patients undergoing ESD with the ROBOPERA. The robotic endoscopic surgical system allows simultaneous grasping, retracting, and lifting of the mucosa during ESD, resulting in exposure of the submucosa. Each of the procedures was recorded and reviewed later by two independent assessors. The outcome measures included the proportion of time that the submucosa was visualized during the procedures, procedural times, perforation rates, clinical outcomes of the procedure Results ESD has been primarily performed for EGC and LGD. Fifteen gastric ESD procedures were performed with ROBOPERA. The median number of graspings required to completely remove the ESD specimen was 4.18. Though the total procedural time was similar, the time required for submucosal dissection was less in the ROBOPERA group. Tearing of ESD specimens was noted (4/15, 26.7%). The endoscopists assessed the ESD procedures in the ROBOPERA group as having lower difficulty. Conclusion The ROBOPERA improved submucosal exposure during gastric ESD and reduced the difficulty of performing the procedures [ABSTRACT FROM AUTHOR]