Robot-assisted endoscopic retrograde cholangiopancreatography: a pilot study

Background: A robotic endoscopic system was developed to assist in endoscopic retrograde cholangiopancreatography (ERCP), enabling endoscopists to reduce occupational radiation exposure without the need for cumbersome protective gear. This pilot trial evaluated the procedural feasibility and clinical potential of this robotic system. Methods: Patients were prospectively recruited at a single tertiary hospital. The primary end points were technical and clinical success rates. The secondary end points included ERCP-related complications, convenience and stability of the robotic system, procedure time, postoperative hospital stay, and hospitalization cost. Results: 13 patients underwent robot-assisted ERCP. Technical success was 100%, with a median procedure time of 38 minutes (range 6-93). The preoperative therapeutic goal was achieved in 12 patients. The median postoperative hospital stay was 3 days (range 1-8). Postoperatively, one patient developed mild pancreatitis and another patient developed moderate cholangitis. Operators reported satisfaction with the system's convenience in 12 of 13 procedures, and with its stability in all 13 procedures. Conclusion: Despite the need for cautious interpretation in this limited cohort, our initial outcomes support the procedural feasibility of the robotic system and hint at its potential to assist in ERCP, but findings must be confirmed in larger studies.