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Open AccessReview

Frontiers of Robotic Gastroscopy: A Comprehensive Review of Robotic Gastroscopes and Technologies

1
Department of Gastroenterology, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland
2
The Centre for Digestive Diseases Endoklinika, 70-535 Szczecin, Poland
3
The BioRobotics Institute, Scuola Superiore Sant’Anna, 56025 Pisa, Italy
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Department of Excellence in Robotics & AI, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
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Key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, Tianjin University, Tianjin 300350, China
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Department of Gastroenterology, Western General Hospital, Edinburgh, Scotland EH4 2XU, UK
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Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland
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Endoscopy Unit, The Royal Infirmary of Edinburgh, Edinburgh, Scotland EH16 4SA, UK
9
Medical School, the University of Edinburgh, Edinburgh, Scotland EH8 9AG, UK
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
These senior authors contributed equally to the work.
Cancers 2020, 12(10), 2775; https://doi.org/10.3390/cancers12102775
Received: 28 August 2020 / Revised: 22 September 2020 / Accepted: 25 September 2020 / Published: 28 September 2020
With the rapid advancements of medical technologies and patients’ higher expectations for precision diagnostic and surgical outcomes, gastroscopy has been increasingly adopted for the detection and treatment of pathologies in the upper digestive tract. Correspondingly, robotic gastroscopes with advanced functionalities, e.g., disposable, dextrous and not invasive solutions, have been developed in the last years. This article extensively reviews these novel devices and describes their functionalities and performance. In addition, the implementation of artificial intelligence technology into robotic gastroscopes, combined with remote telehealth endoscopy services, are discussed. The aim of this paper is to provide a clear and comprehensive view of contemporary robotic gastroscopes and ancillary technologies to support medical practitioners in their future clinical practice but also to inspire and drive new engineering developments.
Upper gastrointestinal (UGI) tract pathology is common worldwide. With recent advancements in robotics, innovative diagnostic and treatment devices have been developed and several translational attempts made. This review paper aims to provide a highly pictorial critical review of robotic gastroscopes, so that clinicians and researchers can obtain a swift and comprehensive overview of key technologies and challenges. Therefore, the paper presents robotic gastroscopes, either commercial or at a progressed technology readiness level. Among them, we show tethered and wireless gastroscopes, as well as devices aimed for UGI surgery. The technological features of these instruments, as well as their clinical adoption and performance, are described and compared. Although the existing endoscopic devices have thus far provided substantial improvements in the effectiveness of diagnosis and treatment, there are certain aspects that represent unwavering predicaments of the current gastroenterology practice. A detailed list includes difficulties and risks, such as transmission of communicable diseases (e.g., COVID-19) due to the doctor–patient proximity, unchanged learning curves, variable detection rates, procedure-related adverse events, endoscopists’ and nurses’ burnouts, limited human and/or material resources, and patients’ preferences to choose non-invasive options that further interfere with the successful implementation and adoption of routine screening. The combination of robotics and artificial intelligence, as well as remote telehealth endoscopy services, are also discussed, as viable solutions to improve existing platforms for diagnosis and treatment are emerging. View Full-Text
Keywords: gastroscopy; gastric cancer; robotic gastroscopy; machine learning; artificial intelligence gastroscopy; gastric cancer; robotic gastroscopy; machine learning; artificial intelligence
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Marlicz, W.; Ren, X.; Robertson, A.; Skonieczna-Żydecka, K.; Łoniewski, I.; Dario, P.; Wang, S.; Plevris, J.N.; Koulaouzidis, A.; Ciuti, G. Frontiers of Robotic Gastroscopy: A Comprehensive Review of Robotic Gastroscopes and Technologies. Cancers 2020, 12, 2775.

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