Hamlyn Centre

Endoscopic robots for next-generation gastrointestinal surgery

Robotic surgery

Self-propelled soft robotic endoscopes for next-generation gastrointestinal surgery and beyond (ROBOGAST)

Lower gastrointestinal (GI) cancers, encompassing the oesophagus, stomach, bowel, and colon, ranked as the second leading cause of cancer-related deaths in the UK in 2015 and feature prominently among the top ten cancers globally.

The NHS 5-year forward view has committed to achieving a 75% early cancer detection rate by 2028, highlighting a substantial unmet need for advancements in endoscopic robotics.

ROBOGAST is a 5-year EPSRC-funded programme (£5 million) within the Hamlyn Centre, that will create the next-generation, self-propelled soft robotic endoscopes designed for the diagnosis and minimally invasive treatment of GI tract conditions.

This research aims to transform early diagnosis and treatment of gut cancers through flexible endoscopy. The envisioned system integrates a soft everting endoscope (see Figure 1) with a probe housing a miniature surgical laser and a robust tissue analysis device.

Image of a  a soft everting endoscope, labelled to show Control box, Colon phantom, Soft everting robot

Figure 1

Figure 1

The proposed instrumented mobile platform is envisioned as a self-propelled apparatus that smoothly navigates the lower GI tract without requiring external pushing. It unfolds into the GI tract, deploying highly adaptable soft and foldable manipulators (see Figure 2) equipped with proprioceptive sensors and a vision system for navigation and real-time diagnostics.

Foldable soft parallel robot

Figure 2

Figure 2

The mobile platform incorporates best-in-class bimanual control and tissue stabilisation capabilities, facilitating complex procedures such as suturing and resection deep within a lumen while providing complete haptic render.

The Hamlyn Centre was established for developing safe, effective and accessible technologies that can reshape the future of healthcare for both developing and developed countries. The Centre focuses on technological innovation with a strong emphasis on clinical translation, resulting in direct patient benefits with global impacts. Hamlyn is at the forefront of research in imaging, sensing and robotics for addressing global health challenges associated with demographic, environmental, social and economic changes. 

Vision to 2050: Pain-free colonoscopies beyond hospitals, Semi-autonomous disease detection, minimally invasive therapy delivery. Faces of people involved in the team and fields: Endoscopy, therapy, materials, control, robotics, imaging. Text reads "Lower-GI cancer is the second cause of cancer death in the UK"

This collaborative project brings together esteemed experts in robotics, medical imaging, control, engineering, surgery, and oncology. Their collective expertise enables the design of a device poised to make a significant impact on healthcare, benefiting a broad spectrum of patients. This project aims to address the following open challenges in the realisation of this vision:

  1. The creation of next-generation self-propelled, steerable endoluminal surgical robots.
  2. Automating critical procedural steps, including instrument navigation, deployment, and detection.
  3. Seamlessly integrating optical and cutting-edge molecular diagnostics to enable real-time, autonomous therapeutic stratification at a cellular level.
  4. Establishing trust by constructing ethical and governance frameworks for forthcoming robotic platforms through engagement and consensus-building with clinicians and patients.

This program holds the promise to revolutionise contemporary endoscopy, bridging the gap between diagnosis and minimally invasive surgical (MIS) intervention to the advantage of millions of patients globally, as it will:

  1. shift away from push-endoscopy and associated limitations, ushering in effective, pain-free GI endoscopies;
  2. integrate diagnosis and treatment into a unified platform, leveraging smart automation to significantly reduce procedure duration;
  3. achieves a substantial decrease in adenoma recurrence by providing cellular-level precision in both diagnosis and treatment.

By 2025, our long-term vision is to redefine an autonomous minimally invasive platform that integrates self-driving microscale soft robotic systems, with optical and biological sensing technologies for endoluminal surgery at the cellular scale and across the patient journey.

The team: Lord Ara Darzi, Nisha Patel, Julian Teare, James Kinross, Zoltan Taktas, Burak Temelkuran, Daniele Dini, Alessandro Astolfi, Enrico Franco, Ferdinando Rodriguez y Baena, George Mylonas, Daniel Elson, Stamatia Giannarou