657 EndoRobotic Submucosal Dissection Using the da Vinci SP System

Dr. Metincan Erkaya

Problem: Conventional endoscopic submucosal dissection (ESD) for large colorectal lesions faces critical limitations: steep learning curve requiring 250+ cases for mastery, poor ergonomics, limited instrument triangulation, and platform instability. These constraints restrict widespread adoption in Western settings, forcing patients toward more radical surgical interventions with significant morbidity and functional impairment. Solution: EndoRobotic Submucosal Dissection (ERSD) using the da Vinci SP platform combines robotic precision with submucosal dissection principles. The technique provides 3D visualization, wristed instrument articulation, and enhanced ergonomics while preserving the submucosal plane and rectal reservoir function. Innovation: ERSD represents the first large-scale integration of single-port robotics with submucosal dissection principles. Unlike full-thickness R-TAMIS, ERSD maintains tissue layer integrity while achieving superior outcomes: 96% en-bloc resection (vs. 70-90% conventional ESD), reduced procedure complexity, and potential for broader surgeon adoption. This democratizes advanced endoluminal surgery for complex colorectal lesions globally.
Procedure Innovation, Gastrointestinal Surgery, large colorectal lesions

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