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This poses a great challenge in developing ESD instruments with small dimensions, flexibility, and high distal dexterity. In this work, we propose the first Transendoscopic Flexible Parallel Continuum Robotic mechanism to develop a miniature dexterous flexible-stiff-balanced Wrist (FPCW). Besides, it can steer multifunctional instruments of diameters 2.5\u00a0mm to 3.5\u00a0mm, including the electrosurgical knife, injection needle, and forceps. Our FPCW instruments are adaptable to commercially available dual-channel endoscopes (diameter: &lt;12\u00a0mm, channel width: 2.8\u00a0mm and around 3.8\u00a0mm). Furthermore, we develop a surgical telerobotic system, called DREAMS (Dual-arm Robotic Endoscopic Assistant for Minimally Invasive Surgery), by using our smallest FPCW instruments for bimanual ESD procedures. First, we conduct a series of experiments to determine the FPCW\u2019s design and kinematics parameters and to verify the mechanical properties of the FPCW instruments\u2019 prototypes, including workspace, stiffness, strength, and teleoperation accuracy. Second, we validate the functionality of the FPCW instruments through ex-vivo tests by performing ESD steps on porcine stomachs. Finally, we perform an invivo test on a live porcine model and showcase that our developed DREAMS can be teleoperated intuitively to perform bimanual ESD efficiently with an average dissection speed of 108.95\u00a0mm\n                    <jats:sup>2<\/jats:sup>\n                    \/min at the greater curvature in gastric body, which demonstrates that our DREAMS has satisfactory maneuverability as well as accuracy and is more competitive than counterpart robotic systems.\n                  <\/jats:p>","DOI":"10.1177\/02783649231209338","type":"journal-article","created":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T03:19:26Z","timestamp":1700277566000},"page":"281-304","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":49,"title":["Transendoscopic flexible parallel continuum robotic mechanism for bimanual endoscopic submucosal dissection"],"prefix":"10.1177","volume":"43","author":[{"given":"Huxin","family":"Gao","sequence":"first","affiliation":[{"name":"The Department of Electronic Engineering, The Chinese University of Hong Kong (CUHK), Hong Kong, China"},{"name":"The Department of Biomedical Engineering, National University of Singapore, Singapore"},{"name":"Shun Hing Institute of Advanced Engineering (SHIAE), The Chinese University of Hong Kong (CUHK), Hong Kong, China"},{"name":"NUS (Suzhou) Research Institute (NUSRI), Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Yang","sequence":"additional","affiliation":[{"name":"The Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Xiao","sequence":"additional","affiliation":[{"name":"The Department of Electronic and Electrical Engineering, Southern University of Science and Technology, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolong","family":"Zhu","sequence":"additional","affiliation":[{"name":"The Department of Electronic and Electrical Engineering, Southern University of Science and Technology, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Department of Biomedical Engineering, National University of Singapore, Singapore"},{"name":"Shun Hing Institute of Advanced Engineering (SHIAE), The Chinese University of Hong Kong (CUHK), Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Hou","sequence":"additional","affiliation":[{"name":"School of Mechanical and Electric Engineering, Soochow University, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huicong","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Mechanical and Electric 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