dissection zone
PDZSeg: Adapting the Foundation Model for Dissection Zone Segmentation with Visual Prompts in Robot-assisted Endoscopic Submucosal Dissection
Xu, Mengya, Mo, Wenjin, Wang, Guankun, Gao, Huxin, Wang, An, Li, Zhen, Yang, Xiaoxiao, Ren, Hongliang
Endoscopic Submucosal Dissection (ESD) is a surgical procedure employed in the treatment of early-stage gastrointestinal cancers [1, 2]. This procedure entails a complex series of dissection maneuvers that require significant skill to determine the dissection zone. In traditional ESD, a transparent cap is employed to retract lesions, which can often obscure the view of the submucosal layer and lead to an incomplete dissection zone. Conversely, our robot-assisted ESD [3] offers better visualization of the submucosal layer, resulting in a more completed dissection zone by utilizing robotic instruments that enable independent control over retraction and dissection. Achieving successful submucosal dissection requires the careful excision of the lesion or mucosal layer along with the complete submucosal layer while ensuring that both the underlying muscular layer and the mucosal surface remain unharmed. If the electric knife inadvertently contacts tissue outside the designated dissection area, it can lead to damage to the muscle layer, increasing the risk of perforations. Such complications not only elevate the surgical risks but can also complicate the patient's recovery. Therefore, it is imperative to maintain a precise dissection zone during endoscopic procedures. Effective guidance can help ensure that surgeons are adept at identifying and adhering to appropriate dissection boundaries and enhance the overall safety of endoscopic submucosal dissection (ESD).