Robotic-assisted endoscopic submucosal dissection: a scoping review of preclinical and early clinical evidence
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By
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Said Alyacoubi
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Kunal Rajput
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Mark Runciman
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Ara Darzi
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Christopher J. Peters
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George Mylonas
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July 1, 2026
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Clinical Scorecard: A Comprehensive Review of Preclinical and Initial Clinical Findings on Robotic-Assisted Endoscopic Submucosal Dissection
At a Glance
| Category | Detail |
|---|
| Condition | Endoscopic Submucosal Dissection (ESD) |
| Key Mechanisms | Robotic assistance provides triangulation, active countertraction, enhanced visualisation, and improved ergonomics. |
| Target Population | Patients with precancerous lesions and early-stage cancers of the gastrointestinal tract. |
| Care Setting | Clinical and preclinical settings evaluating robotic endoscopic systems. |
Key Highlights
- ESD offers superior curative resection rates compared to EMR.
- Robotic-assisted ESD (R-ESD) may reduce procedural demands and accelerate skill acquisition.
- Traction-assisted ESD leads to shorter procedure times and reduced technical difficulty.
Guideline-Based Recommendations
Diagnosis
- Evaluate the feasibility and safety of robotic-assisted ESD in early clinical evidence.
Management
- Utilize robotic systems to enhance ESD procedures.
Monitoring & Follow-up
- Assess outcomes such as resected specimen area and perforation rates.
Risks
- Higher complication risk associated with ESD compared to EMR.
Patient & Prescribing Data
Patients undergoing ESD for gastrointestinal lesions.
Robotic systems may facilitate wider adoption of ESD across varying levels of endoscopic expertise.
Clinical Best Practices
- Implement traction methods to improve dissection efficiency.
- Adopt robotic platforms to enhance procedural ergonomics.
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