Reliable anchoring is a critical enabling technology for stable manipulations within complex human lumen environments. Existing anchoring technologies may cause damage to the soft tissue or fail to adapt to the complex and variable shape of lumen. We propose a complex balloon anchoring mechanism driven by multimodal pressure, which could form a stable adhesion between the anchoring unit and the lumen. The combined driving pressures also enable shape adaptation to expand or contract as required. The manufacturing process for the balloon-type anchoring unit is detailed, which realizes high diameter/length ratio. The mechanics model is established, describing the deformation of the anchoring unit. Anchoring experiments were conducted in phantoms, mimicking both straight and tapered lumens, and ex vivo tissues. Anchoring performances were evaluated by comparing them with positive pressure-actuated single balloon and double balloon. The results demonstrate that the proposed anchoring technology achieves more reliable anchoring performance and adaptively adjusts the anchoring dimension.
LeeJH, KediaP, StavropoulosSN, et al.AGA clinical practice update on endoscopic management of perforations in gastrointestinal tract: Expert review. Clin Gastroenterol Hepatol, 2021; 19(11):2252–2261.e2.
2.
LiB, ShiQ, XuEP, et al.Prediction of technically difficult endoscopic submucosal dissection for large superficial colorectal tumors: A novel clinical score model. Gastrointest Endosc, 2021; 94(1):133–144.e3.
3.
PanTL, LeiMC, NgWY, et al.Analytical modeling of the interaction between soft balloon-like actuators and soft tubular environment for gastrointestinal inspection. Soft Robot, 2022; 9(2):386–398.
4.
BettenworthD, BokemeyerA, KouL, et al.Systematic review with meta-analysis: Efficacy of balloon-assisted enteroscopy for dilation of small bowel Crohn’s disease strictures. Aliment Pharmacol Ther, 2020; 52(7):1104–1116.
5.
TanisakaY, RyozawaS, ItoiT, et al.Efficacy and factors affecting procedure results of short-type single-balloon enteroscopy-assisted ERCP for altered anatomy: A multicenter cohort in Japan. Gastrointest Endosc, 2022; 95(2):310–318.e1.
6.
JacquesJ, AlbouysJ, GuyotA, et al.Endoscopic submucosal dissection of a laterally spreading tumor in the right colon with a gastroscope after shortening the colon using a new double-balloon platform. Endoscopy, 2019; 51(12):E364–E365.
7.
UrakawaS, HirashitaT, HirashitaY, et al.Use of endoscopic sleeve to achieve full-thickness endoscopic resection of malignant polyp under direct vision. Endoscopy, 2022; 54(7):E350–E352.
8.
LeeD, JoeS, JungJH, et al.A simple and reliable reel mechanism-based robotic colonoscope for high mobility. Proc Inst Mech Eng Pt C J Mech Eng Sci, 2018; 232(16):2753–2763.
9.
LeeD, JoeS, KangH, et al.A reel mechanism-based robotic colonoscope with high safety and maneuverability. Surg Endosc, 2019; 33(1):322–332.
10.
ManfrediL, CapocciaE, CiutiG, et al.A Soft Pneumatic Inchworm Double balloon (SPID) for colonoscopy. Sci Rep, 2019; 9(1):11109.
11.
WangK, GeY, JinX. A micro soft robot using inner air transferring for colonoscopy. In: 2013 IEEE International Conference on Robotics and Biomimetics (ROBIO). IEEE; 2013; pp. 1556–1561.
12.
HeungH, ChiuPW, LiZ. Design and prototyping of a soft earthworm-like robot targeted for GI tract inspection. In: 2016 IEEE international conference on robotics and biomimetics (ROBIO). IEEE; 2016; pp. 497–502.
13.
PoonCC, LeungB, ChanCK, et al.Design of wormlike automated robotic endoscope: Dynamic interaction between endoscopic balloon and surrounding tissues. Surg Endosc, 2016; 30(2):772–778.
14.
LiY, PeineJ, MencattelliM, et al.A soft robotic balloon endoscope for airway procedures. Soft Robot, 2022; 9(5):1014–1029.
15.
BernthJE, ArezzoA, LiuH. A novel robotic meshworm with segment-bending anchoring for colonoscopy. IEEE Robot Autom Lett, 2017; 2(3):1718–1724.
16.
ZhangB, FanY, YangP, et al.Worm-like soft robot for complicated tubular environments. Soft Robot, 2019; 6(3):399–413.
LuoX, DongX, ZhaoH, et al.Near-infrared responsive gecko-inspired flexible arm gripper. Materials Today Physics, 2022; 29:100919.
19.
WuY, LiX, TianH, et al.Microtemplated electrowetting for fabrication of shape-controllable microdomes in extruded microsucker arrays toward Octopus-inspired dry/wet adhesion. Adv Funct Materials, 2023; 33(7):2210562.
20.
NguyenP, HoVA. Grasping interface with wet adhesion and patterned morphology: Case of thin shell. IEEE Robot Autom Lett, 2019; 4(2):792–799.
21.
ZhangX, ChenG, CaiL, et al.Bioinspired pagoda-like microneedle patches with strong fixation and hemostasis capabilities. Chem Eng J, 2021; 414:128905.
22.
YangSY, O’CearbhaillED, SiskGC, et al.A bio-inspired swellable microneedle adhesive for mechanical interlocking with tissue. Nat Commun, 2013; 4(1):1702.
23.
LeeYW, ChunS, SonD, et al.A tissue adhesion-controllable and biocompatible small-scale hydrogel adhesive robot. Adv Mater, 2022; 34(13):2109325.
24.
WangY, YangX, ChenY, et al.A biorobotic adhesive disc for underwater hitchhiking inspired by the remora suckerfish. Sci Robot, 2017; 2(10):eaan8072.
25.
ZhangP, WuZ, ChenD, et al.Autonomous dynamic hitch-hiking control of a bionic robotic remora. IEEE Trans Ind Electron, 2024; 71(3):2893–2902.
26.
RenX, PanT, DarioP, et al.Design and analytical modeling of a dumbbell-shaped balloon anchoring actuator for safe and efficient locomotion inside gastrointestinal tract. Soft Robot, 2025; 12(3):374–385.
27.
WengZ, WangZ, XuC, et al.Adaptive and robust switchable adhesion system: Bio-inspired synergistic integration from octopuses and geckos. Soft Robot, 2025; doi: 10.1089/soro.2024.0097
28.
ParkSJ. Tips and tricks for better endoscopic treatment of colorectal tumors: Usefulness of cap and band in colorectal endoscopic mucosal resection. Clin Endosc, 2013; 46(5):492–494.
29.
BhattacharyyaR, ChedgyF, KandiahK, et al.Endocuff-assisted vs. standard colonoscopy in the fecal occult blood test-based UK Bowel Cancer Screening Programme (E-cap study): A randomized trial. Endoscopy, 2017; 49(11):1043–1050.
30.
González-FernándezC, García-RangelD, Aguilar-OlivosNE, et al.Higher adenoma detection rate with the endocuff: A randomized trial. Endoscopy, 2017; 49(11):1061–1068.
31.
RuncimanM, AveryJ, ZhaoM, et al.Deployable, variable stiffness, cable driven robot for minimally invasive surgery. Front Robot AI, 2019; 6:141.
32.
YangJ, RuncimanM, AveryJ, et al.A soft inflatable robot driven by hydraulic folded pouch actuators for minimally invasive surgery. IEEE Robot Autom Lett, 2024; 9(5):4870–4877.
33.
VrielinkTJO, ZhaoM, DarziA, et al.ESD CYCLOPS: A new robotic surgical system for GI surgery. In: 2018 IEEE international conference on robotics and automation (ICRA). IEEE; 2018; pp. 150–157.
34.
HanD, YanG, WangZ, et al.The modelling, analysis, and experimental validation of a novel micro-robot for diagnosis of intestinal diseases. Micromachines (Basel), 2020; 11(10):896.
35.
GaoH, YangX, XiaoX, et al.Transendoscopic flexible parallel continuum robotic mechanism for bimanual endoscopic submucosal dissection. Int J Rob Res, 2024; 43(3):281–304.
36.
KimJ, ChoiWY, KangS, et al.Continuously variable stiffness mechanism using nonuniform patterns on coaxial tubes for continuum microsurgical robot. IEEE Trans Robot, 2019; 35(6):1475–1487.
37.
ParkS, KimJ, KimC, et al.Design optimization of asymmetric patterns for variable stiffness of continuum tubular robots. IEEE Trans Ind Electron, 2022; 69(8):8190–8200.
38.
LuoX, SongD, ZhangZ, et al.A novel distal hybrid pneumatic/cable-driven continuum joint with variable stiffness capacity for flexible gastrointestinal endoscopy. Adv Intell Syst, 2023; 5(6):2200403.
39.
MazzolaiB, MondiniA, Del DottoreE, et al.Roadmap on soft robotics: Multifunctionality, adaptability and growth without borders. Multifunct Mater, 2022; 5(3):032001.
40.
YeohOH. Some forms of the strain energy function for rubber. Rubber Chem Technol, 1993; 66(5):754–771.
41.
RivlinR. Large elastic deformations. In: Collected Papers of RS Rivlin: Volume I and II. Springer; 1997; pp. 318–351.
42.
SangJ, XingS, LiuH, et al.Large deformation and stability analysis of a cylindrical rubber tube under internal pressure. J Theor Appl Mech, 2017; 55(1):177–188.
43.
ChiY, LiY, ZhaoY, et al.Bistable and multistable actuators for soft robots: Structures, materials, and functionalities. Adv Mater, 2022; 34(19):2110384.
44.
GeY, ZongR, ChenX, et al.An origami-inspired endoscopic capsule with tactile perception for early tissue anomaly detection. IEEE Robot Autom Lett, 2024; 9(11):10018–10025.
45.
HabtiM, BénardF, ArutiunianA, et al.Development and Learner-based assessment of a novel, customized, 3D printed small bowel simulator for hand-sewn anastomosis training. Cureus, 2021; 13(12):e20536.
46.
GuanY, WorrellRT, PrittsTA, et al.Intestinal ischemia-reperfusion injury: Reversible and irreversible damage imaged in vivo. Am J Physiol Gastrointest Liver Physiol, 2009; 297(1):G187–G196.
47.
DerikxJP, MatthijsenRA, de BruïneAP, et al.A new model to study intestinal ischemia-reperfusion damage in man. J Surg Res, 2011; 166(2):222–226.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
