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We developed the Autonomous Colonoscope Robot System (ACRS), based on the Endoscopic Operation Robot version 4, to evaluate whether expert-derived operational data can enable autonomous colonoscope insertion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>ACRS was trained using insertion data obtained from an expert endoscopist operating a standardized colonoscopy training model. Automated insertions were evaluated using Pattern 1 of the model, a highly controlled configuration without substantial loop formation. Completely automated insertions were designated Level 4, whereas insertions requiring some manual assistance were designated Level 3. Level 4 insertion times were compared with manual insertions performed by an expert and trainees.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 72 automated insertions at Level 3 or higher, 62 are classified as Level 4, giving a success rate of 86.1% (95% CI, 75.9\u201393.1%). The average insertion time for Level 4 procedures is 2.92\u2009\u00b1\u20091.20\u2009minutes, significantly longer than that of the expert (1.43\u2009\u00b1\u20090.32\u2009minutes), but comparable to the time taken by trainees (2.97\u2009\u00b1\u20091.32\u2009minutes; errors are standard deviations).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ACRS demonstrates proof-of-concept feasibility for autonomous colonoscope insertion under simplified, controlled model conditions. Further validation in more complex models, animal studies, and clinical settings is required before translational application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s43856-026-01747-8","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T21:19:08Z","timestamp":1782854348000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["In vitro development of the Autonomous Colonoscope Robot System (ACRS) for fully automated colonoscope insertion"],"prefix":"10.1038","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0444-4739","authenticated-orcid":false,"given":"Keiichiro","family":"Kume","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuru","family":"Taira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seigo","family":"Terao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuo","family":"Sakai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"1747_CR1","first-page":"209","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung, H. et al. 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