{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:38:48Z","timestamp":1791463128939,"version":"4.3.4"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"02","funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82470695"],"award-info":[{"award-number":["82470695"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Taishan Scholar Project of Shandong Province","award":["tsqn202312333"],"award-info":[{"award-number":["tsqn202312333"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Several animal studies have demonstrated the safety and efficacy of a flexible auxiliary single-arm transluminal endoscopic robot in assisting gastric endoscopic submucosal dissection (ESD). This study aimed to assess its performance for the first time in a real clinical setting.<\/jats:p>\n                  <jats:p>We conducted this prospective, single-blind, pilot randomized controlled trial at a tertiary teaching hospital. Patients with gastric high grade intraepithelial neoplasia or intramucosal carcinoma were randomized to either robot-assisted or conventional ESD. The primary outcome was procedure time. Secondary outcomes included R0 and en bloc resection rates, dissection time, and procedure-related complications.<\/jats:p>\n                  <jats:p>48 patients underwent successful procedures without perforation. Despite no significant difference in procedure time between robot-assisted and conventional ESD (58.21 vs. 39.21 minutes; P = 0.08), a learning curve effect was observed, with shorter procedure times in the last 12 cases with robot assistance compared with the last 12 conventional ESDs (56.82 vs. 63.10 minutes; P = 0.71). Muscular injuries were significantly reduced with robot assistance (1.50 vs. 9.00; P &lt; 0.001). No significant difference was found in R0 (95.8% vs. 91.7%; P &gt; 0.99) and en bloc (100% vs. 95.8%; P &gt; 0.99) resection rates between robot-assisted and conventional ESD, respectively.<\/jats:p>\n                  <jats:p>This preliminary evidence supports the feasibility of robot-assisted gastric ESD.<\/jats:p>","DOI":"10.1055\/a-2699-5861","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:25:18Z","timestamp":1764721518000},"page":"184-192","source":"Crossref","is-referenced-by-count":9,"title":["Safety and efficacy of traction robot-assisted endoscopic submucosal dissection for early gastric cancer: a randomized pilot trial"],"prefix":"10.1055","volume":"58","clinical-trial-number":[{"clinical-trial-number":"nct06748352","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Ruixin","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, China"},{"name":"Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5637-7796","authenticated-orcid":false,"given":"Rui","family":"Ji","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, China"},{"name":"Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maosheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, China"},{"name":"Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, China"},{"name":"Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaoyang","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, China"},{"name":"Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxiao","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, China"},{"name":"Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9783-169X","authenticated-orcid":false,"given":"Zhen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, China"},{"name":"Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanqing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, China"},{"name":"Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuli","family":"Zuo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, China"},{"name":"Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan, China"},{"name":"Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1887","DOI":"10.1053\/j.gastro.2018.01.068","article-title":"Endoscopic submucosal dissection: indications and application in Western endoscopy practice","volume":"154","author":"MJ Bourke","year":"2018","journal-title":"Gastroenterology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1055\/a-1106-3761","article-title":"Efficacy and safety of traction-assisted endoscopic submucosal dissection: a meta-regression of randomized clinical trials","volume":"52","author":"YF Su","year":"2020","journal-title":"Endoscopy"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1055\/a-2276-0546","article-title":"Multicenter prospective randomized controlled clinical trial comparing the pocket-creation method with and without single-clip traction of colonic endoscopic submucosal dissection","volume":"56","author":"T Morikawa","year":"2024","journal-title":"Endoscopy"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"E1041","DOI":"10.1055\/a-2155-7172","article-title":"Two-step traction-assisted endoscopic submucosal dissection for a gastric neoplasm using a clip with a traction band and thread","volume":"55","author":"K Nishioka","year":"2023","journal-title":"Endoscopy"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"451","DOI":"10.4253\/wjge.v8.i12.451","article-title":"Effectiveness of clip-and-snare method using pre-looping technique for gastric endoscopic submucosal dissection","volume":"8","author":"N Yoshida","year":"2016","journal-title":"World J Gastrointest Endosc"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/j.gie.2020.09.049","article-title":"Comparing a conventional and a spring-and-loop with clip traction method of endoscopic submucosal dissection for superficial gastric neoplasms: a randomized controlled trial (with videos)","volume":"93","author":"M Nagata","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"E1186","DOI":"10.1055\/a-2186-5029","article-title":"Magnet-assisted traction method helps to reduce the difficulty of esophageal endoscopic submucosal dissection","volume":"55","author":"Y Gao","year":"2023","journal-title":"Endoscopy"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.gie.2022.01.004","article-title":"Simplified robot-assisted endoscopic submucosal dissection for esophageal and gastric lesions: a randomized controlled porcine study (with videos)","volume":"96","author":"R Ji","year":"2022","journal-title":"Gastrointest Endosc"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"5510","DOI":"10.1007\/s00464-022-09194-x","article-title":"A novel flexible auxiliary single-arm transluminal endoscopic robot facilitates endoscopic submucosal dissection of gastric lesions (with video)","volume":"36","author":"XX Yang","year":"2022","journal-title":"Surg Endosc"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1111\/den.14438","article-title":"Robot-assisted endoscopic submucosal dissection contributes to efficient and safe learning for novices: prospective pilot cross-over ex vivo study (with video)","volume":"35","author":"XX Yang","year":"2023","journal-title":"Dig Endosc"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"i5239","DOI":"10.1136\/bmj.i5239","article-title":"CONSORT 2010 statement: extension to randomised pilot and feasibility trials","volume":"355","author":"SM Eldridge","year":"2016","journal-title":"BMJ"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1055\/a-2031-0874","article-title":"Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review","volume":"55","author":"D Lib\u00e2nio","year":"2023","journal-title":"Endoscopy"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1974","DOI":"10.1007\/s00464-008-9988-7","article-title":"Predictors of immediate bleeding during endoscopic submucosal dissection in gastric lesions","volume":"23","author":"SW Jeon","year":"2009","journal-title":"Surg Endosc"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1007\/s10151-019-02102-x","article-title":"Endoscopic submucosal dissection of distal intestinal tumors using grasping forceps for traction","volume":"23","author":"F Wang","year":"2019","journal-title":"Tech Coloproctol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"862","DOI":"10.14309\/ajg.0000000000001100","article-title":"Endoscopic traction techniques","volume":"116","author":"S Zheng","year":"2021","journal-title":"Am J Gastroenterol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"E49","DOI":"10.1055\/a-2227-6465","article-title":"Endoscopic submucosal dissection of early gastric angle cancer by using a simplified robot-assisted device for traction","volume":"56","author":"C Cui","year":"2024","journal-title":"Endoscopy"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1007\/s00464-012-2583-y","article-title":"Ex vivo comparative study using the Endolifter as a traction device for enhancing submucosal visualization during endoscopic submucosal dissection","volume":"27","author":"AY Teoh","year":"2013","journal-title":"Surg 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Moura","year":"2019","journal-title":"Gastrointest Endosc"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2699-5861.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T23:33:16Z","timestamp":1769124796000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2699-5861"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,2]]},"references-count":20,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2026,1,22]]},"published-print":{"date-parts":[[2026,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2699-5861","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,2]]}}}