Endoscopic Submucosal Dissection (ESD)- Master Slave Robotic System - Human Study (ESD)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01394861
Recruitment Status : Completed
First Posted : July 15, 2011
Last Update Posted : March 6, 2012
Nanyang Technological University
Information provided by (Responsible Party):
Asian Institute of Gastroenterology, India

Brief Summary:
The purpose of this study is to evaluate the feasibility, ease and safety of flexible endoscopic robotic system to treat early gastric cancer in humans.

Condition or disease Intervention/treatment Phase
Endoscopic Submucosal Dissection Device: ESD using Master Slave Robotic System Early Phase 1

Detailed Description:


To evaluate the feasibility and safety of Endoscopic Submucosal Dissection (ESD) using Master Slave Endoscopic Robotic System in humans.

Material and Methods:

To assess the feasibility and safety of ESD in humans, 3 patients with early gastric cancer or sessile polyp in the stomach with no evidence of involvement of deeper layer will be included in the study. The depth of involvement is evaluated by endoscopic ultrasound. An informed consent about the nature of the procedure, complications and the need for surgery will be explained to the patient. The master slave robot system (Human master robotic interface, telesurgical workstation and slave manipulator) and forward viewing therapeutic endoscope with 2 operating channels (GIF -2T160) will be used. The master controller controls the slave manipulator with electrical cables through a software interface. The slave manipulator in turn controls the end effectors (Monopolar 'L' hook and grasper) through cables passed through the two operating channels of the endoscope. The master slave robot system will be set up by the engineers from the Nanyang Technological University, Singapore. The endoscope will be connected to the high definition visual display and will be recorded throughout the procedure. Another high definition monitor will be set up for the surgeon/endoscopist who will control the MASTER at the console and the movements at the console will be continuously recorded. Monopolar electrocautery (ERBE) will be set up and tested. The settings for cutting and blend will be the same as used in the conventional ESD.

The therapeutic endoscope and the end effectors will be sterilised by immersing the scope in glutaraldehyde for 30 minutes before the procedure.

Patient will be kept fasting for 8 hours before the procedure. Under IV sedation, with the patient in left lateral position, end viewing diagnostic gastroscope is passed with an overtube. The lesion will be identified. Then the lesion will be marked by electrocautery (ERBE) all around. Then Gelofusine® (containing 4% succinylated gelatin, sodium hydroxide) stained with methylene blue will be injected submucosally under the lesion to create a cushion for ESD. Then IT knife is used for the mucosal cut all around the lesion. The double channel endoscope (GIF 2T160) will be exchanged through the overtube for the conventional endoscope after checking the system. Then submucosal dissection of the lesion will be performed, using the Master.

The data will be captured in the standard proforma for each patient. The endoscopic view and the external view of the MASTER will be recorded throughout the procedure.

Analysis - Efficacy and Safety outcomes:

The ease of the procedure (grasping, retraction, triangulation and complete excision), time required for mucosal cutting and submucosal dissection and completeness of the procedure will be analysed. Safety outcomes include intraoperative, immediate postoperative complications (bleeding, perforation) and the need for laparotomy will be assessed. Delayed Complications if any will be recorded for up to 30 days after the procedure.

Statistical Methodology:

As this is a pilot study, no sample size calculation was done. The aim is to perform the procedure in 3 subjects. Descriptive statistics will be used to describe safety data.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 3 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Study Start Date : June 2011
Primary Completion Date : July 2011
Study Completion Date : October 2011

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Endoscopy
U.S. FDA Resources

Arm Intervention/treatment
Experimental: ESD using MASTER Slave Robotic System Device: ESD using Master Slave Robotic System
Endoscopic submucosal dissection of early gastric cancer or broad sessile polyp using Master Slave Robotic System

Primary Outcome Measures :
  1. Ease of the procedure [ Time Frame: 30 days ]
    The ease of the procedure (grasping, retraction, triangulation), time required for mucosal cutting and submucosal dissection

Secondary Outcome Measures :
  1. Completeness of the Procedure [ Time Frame: 30 days ]
    Completeness of the procedure is evaluated during the procedure by endoscopy and gross examination of the resected specimen followed by histopathological examination.

  2. Immediate Procedure Related Complications [ Time Frame: 30 days ]
    Bleeding or Perforation during and immediately after the procedure

  3. Delayed Procedure Related Complications [ Time Frame: 30 days ]
    Any complications (Delayed Bleeding or Perforation) related to the procedure up to thirty days post procedure.

Information from the National Library of Medicine

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Ages Eligible for Study:   25 Years to 60 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

-Early Gastric Cancer or Gastric sessile polyp with dysplasia

Exclusion Criteria:

  • Gastric Cancer with involvement of muscle layer
  • Advanced Gastric cancer

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01394861

Asian Institute Of Gastroenterology India
Hyderabad, Andhra Pradesh, India, 500082
Sponsors and Collaborators
Asian Institute of Gastroenterology, India
Nanyang Technological University
Principal Investigator: Nageshwar Reddy Duvvuru, MD, DM, DSc, FAMS, FRCP Asian Institute of Gastroenterology, India
Principal Investigator: Louis Soo Jay Phee, BEng, MEng, PhD Nanyang Technological University

Responsible Party: Asian Institute of Gastroenterology, India Identifier: NCT01394861     History of Changes
Other Study ID Numbers: AIG-GI2011-04
First Posted: July 15, 2011    Key Record Dates
Last Update Posted: March 6, 2012
Last Verified: March 2012

Keywords provided by Asian Institute of Gastroenterology, India:
Endoscopic Submucosal Dissection
Early Gastric Cancer
Flexible Endoscopic Robotic System
Master Slave Robot
Ease & Safety of ESD by Flexible Master Slave Robotic System