Robotic Flexible Magnetic Retractor for Dynamic Tissue Manipulation in Endoscopic Submucosal Dissection

Endoscopic submucosal dissection (ESD) is a procedure targeted for early gastrointestinal cancer. Traction plays a crucial role in enhancing the efficiency of cutting lesions, thereby reducing procedural complexity and duration. From the perspective of traction devices, current non-magnetic ones hold shortcomings in complicating the workspace in directional tissue manipulation; Current magnetic traction devices cannot be prepared before the procedure, and require the withdrawal of endoscope in the midway to re-introduce the magnetic retractor to the lesion site. Towards these plights, this paper introduces a robotic flexible magnetic retractor designed for tissue manipulation during ESD. Precisely, the flexible prototype can be seamlessly inserted through the instrument channel of an endoscope to the lesion site without the need for endoscope withdrawal. Moreover, the introduction of robotic magnetic actuation enhances the agile control of magnetic retractors while alleviating the surgeon's workload in magnetic-retractor-assisted ESD. The experimental results validate the functionality and efficacy of the prototype magnetic retractor in magnetic traction-assisted ESD procedures. The retractor demonstrated its ability to provide adequate traction and accomplish clinical tasks. This innovative approach holds promise for enhancing the efficiency and outcomes of ESD procedures, offering a compelling alternative to traditional traction methods.