Robotic‐Assisted Bile Duct Cannulation During Endoscopic Retrograde Cholangiopancreatography: A Randomised Controlled Crossover Animal Study

INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging, with high operator radiation exposure, physical strain, and a steep learning curve, necessitating a robotic solution. This study evaluated robotic-assisted ERCP feasibility and efficacy in an animal model. METHODS: In this randomised controlled crossover study, three experienced endoscopists performed 24 ERCP procedures (12 robotic-assisted vs. 12 manual) on four beagles using the YunSRobot system. Primary outcomes included papilla positioning maintenance, cannulation time, and success rate. RESULTS: Robotic-assisted ERCP demonstrated superior papilla positioning (95.74% vs. 77.25%, p < 0.01), indicating more endoscopic stability during cannulation. The successful cannulation rate was identical in both groups (83.3%). The robotic group required fewer attempts (2.0 vs. 3.5) and experienced no scope dislocations (0 vs. 5). No severe adverse events occurred in either group. CONCLUSIONS: Robotic-assisted ERCP is feasible, safe, and effective, offering significantly improved endoscopic stability with comparable cannulation success to manual techniques.