Guidelines for Robotic Flexible Endoscopy at the Time of COVID-19

• Main Authors: Onaizah Onaizah, Zaneta Koszowska, Conchubhair Winters, Venkatamaran Subramanian, David Jayne, Alberto Arezzo, Keith L. Obstein, Pietro Valdastri
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-02-01
• Series: Frontiers in Robotics and AI
• Subjects: robotic flexible endoscopy; endoscopes; gastrointestinal; infection control; aerosol generating procedure; COVID-19
• Online Access: https://www.frontiersin.org/articles/10.3389/frobt.2021.612852/full

Flexible endoscopy involves the insertion of a long narrow flexible tube into the body for diagnostic and therapeutic procedures. In the gastrointestinal (GI) tract, flexible endoscopy plays a major role in cancer screening, surveillance, and treatment programs. As a result of gas insufflation during the procedure, both upper and lower GI endoscopy procedures have been classified as aerosol generating by the guidelines issued by the respective societies during the COVID-19 pandemic—although no quantifiable data on aerosol generation currently exists. Due to the risk of COVID-19 transmission to healthcare workers, most societies halted non-emergency and diagnostic procedures during the lockdown. The long-term implications of stoppage in cancer diagnoses and treatment is predicted to lead to a large increase in preventable deaths. Robotics may play a major role in this field by allowing healthcare operators to control the flexible endoscope from a safe distance and pave a path for protecting healthcare workers through minimizing the risk of virus transmission without reducing diagnostic and therapeutic capacities. This review focuses on the needs and challenges associated with the design of robotic flexible endoscopes for use during a pandemic. The authors propose that a few minor changes to existing platforms or considerations for platforms in development could lead to significant benefits for use during infection control scenarios.