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Development of Flexible Surgical Robot and Performance of Animal Experiment

Robotic surgery is a hot topic in medical community. However, the conventional methods of using a surgical robot have various limitations. For example, laparoscopic surgery requires many holes into the abdomen, and it may not be smoothly performed with the rigid laparoscope and instruments. That is because the lesions in our body are often located at positions that are difficult to find. Thus, the works by Professor Dong-Soo Kwon are drawing attention, as he developed the world’s first flexible surgical robot based on Korean domestic technologies. The flexible robot method is emerging as an innovative alternative in the field of robotic surgery, because it enables surgeons to perform the operation at various positions in the body with minimum incisions.

|Opening the Blue Ocean of Flexible Surgical Robot|

Development of platform for maximizing the functions of flexible surgical robot
“In some cases, the surgery for early-stage stomach cancer or colon cancer can be carried out directly inside the stomach or large intestines without an external incision. Of course, that’s difficult by the conventional method. Simple endoscopy may be performed by approaching the organs through the winding surfaces of the body, but surgery may not be carried out in that way. To overcome such limitations, we developed a standard platform with the ‘overtube’ at the core.”
The overtube, which Professor Kwon considers as the essence of his work, is a flexible apparatus that corresponds to an arm of a surgical robot. The ‘overtube’ can be used to perform a surgery, as an endoscopic camera and several surgical instruments are mounted on it. The ‘overtube’ should be capable of applying an appropriate force to lift and cut a surgical tissue in the body according to the surgeon’s manipulation, like a human arm. For this purpose, the research team designed the overtube to have a serially joint-connected structure, and a wire connected with an external actuator was employed to transmit the force between the joints. “You know that the body of a snake consists of numerous nodes. The overtube is the same.”

The advantage of the flexible robot is that it enables an surgeon to approach the surgical part with minimum incisions. Renal stones can also be removed by inserting the overtube through the urinary tract without relying on the conventional surgical method or shock wave lithotripsy. The research group successfully performed animal experiments, such as removing a gastric tissue through the esophagus and sectioning a tumor below the lingual root. The success rate is 100% in the clinical study that is being conducted in cooperation with the Seoul National University Hospital and the Yonsei University Hospital (As of January 2022, the surgery has been successfully carried out with 22 subjects among the 47 subjects participating in the clinical study.). Professor Kwon proudly commented, “The biggest advantage of our system is that it is a platform that allows for performing different surgeries by using the overtubes of various lengths (100/120/160 cm) and diameters (2.8/5/15/25 mm).“

A giant step to commercialization after demonstration
Professor Kwon said that the present work is Version 2.0 of the K-FLEX system that was presented in 2018. In the Surgical Robot Challenge 2018’ held in that year in UK, his team won both the Best Application Award and the Overall Winner, beating the surgical robot powerhouses. So, the present work represents an advancement from the previous system. The research team is adding fresh fuel to the commercialization of the technology by founding a surgical robot start-up (EasyEndo Surgical Inc.), and looking forward to the acquisition of the MFDS (Ministry Of Food And Drug Safety) certificate and the release of their product to the market. There are some areas that require improvement, such as the product certification process and the insurance fee setup, but they are continuously moving forward to the global surgical robot market.

Prof.Dong-Soo Kwon
2021 Annual Report

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