Current Status of Robotic Therapeutic Endoscopic Platforms

Advances in gastrointestinal endoscopy have expanded its role from diagnosis to definitive therapy, leading to a paradigm shift in the management of gastrointestinal diseases. As therapeutic endoscopic procedures become increasingly complex, there is a growing demand for enhanced precision, stability, and control beyond the capabilities of conventional endoscopes. In response, various robotic endoscopic platforms have been developed to improve visualization, dexterity, and procedural safety, particularly for technically demanding interventions such as endoscopic submucosal dissection (ESD). Robotic therapeutic endoscopy systems can be broadly categorized into multitasking robotic platforms and robotic add-on platforms. Multitasking platforms enable bimanual manipulation, triangulation, and effective tissue traction but are often limited by high cost, system complexity, and workflow constraints. In contrast, robotic add-on platforms are designed to integrate with conventional endoscopes, offering improved maneuverability and traction with minimal disruption to clinical practice. Recent preclinical and early clinical studies, including first-in-human and randomized pilot trials, have demonstrated the feasibility and safety of robotic-assisted ESD, with potential benefits in procedural efficiency, learning curve reduction, and operator workload. Despite ongoing challenges related to cost-effectiveness, device integration, and widespread commercialization, robotic endoscopy represents a promising therapeutic platform. Continued technological refinement and accumulation of clinical evidence are expected to further define its role in advancing precision, standardization, and accessibility in therapeutic gastrointestinal endoscopy.