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Compared with conventional percutaneous surgery, ESD is much less invasive and provides a high quality of life for the patient because it does not require a skin incision, and the organ is preserved. However, the operator must be highly skilled because ESD requires using a flexible endoscope with energy devices, which have limited degrees of freedom. To facilitate easier manipulation of these flexible devices, we developed a surgical robot comprising a flexible endoscope and two articulating instruments. The robotic system is based on a conventional flexible endoscope, and an extrapolated motor unit moves the endoscope in all its degrees of freedom. The instruments are thin enough to allow insertion of two instruments into the endoscope channel, and each instrument has a bending section that allows for up\u2013down, right\u2013left, and forward\u2013backward motion. In this study, we performed an<jats:italic>ex vivo<\/jats:italic>feasibility evaluation using the proposed robotic system for ESD in a porcine stomach. The procedure was successfully performed by five novice operators without complications. Our findings demonstrated the feasibility of the proposed robotic system and, furthermore, suggest that even operators with limited experience can use this system to perform ESD.<\/jats:p>","DOI":"10.34133\/2020\/8378025","type":"journal-article","created":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T23:45:07Z","timestamp":1607211907000},"source":"Crossref","is-referenced-by-count":35,"title":["Surgical Robot for Intraluminal Access: An<i>Ex Vivo<\/i>Feasibility Study"],"prefix":"10.34133","volume":"2020","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2314-6921","authenticated-orcid":false,"given":"Ryu","family":"Nakadate","sequence":"first","affiliation":[{"name":"Center for Advanced Medical Innovation, Kyushu University, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsutomu","family":"Iwasa","sequence":"additional","affiliation":[{"name":"Kitakyushu Municipal Medical Center, Kyushu University, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0642-0511","authenticated-orcid":false,"given":"Shinya","family":"Onogi","sequence":"additional","affiliation":[{"name":"Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jumpei","family":"Arata","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Kyushu University, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susumu","family":"Oguri","sequence":"additional","affiliation":[{"name":"Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuharu","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Kyushu Central Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiko","family":"Akahoshi","sequence":"additional","affiliation":[{"name":"Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Eto","sequence":"additional","affiliation":[{"name":"Center for Advanced Medical Innovation, Kyushu University, Japan"},{"name":"Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Japan"},{"name":"Department of Urology, Kyushu University, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5140-0982","authenticated-orcid":false,"given":"Makoto","family":"Hashizume","sequence":"additional","affiliation":[{"name":"Kyushu University, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"221","published-online":{"date-parts":[[2020,12,5]]},"reference":[{"issue":"4","key":"e_1_3_3_1_2","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1016\/S0016-5107(99)70084-2","article-title":"A new endoscopic mucosal resection procedure using an insulation-tipped electrosurgical knife for rectal flat lesions: report of two cases","volume":"50","author":"Gotoda T.","year":"1999","unstructured":"T. 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