Bladder cancer ranks as the 10th most common cancer globally. Currently, the standard surgical approach for bladder tumor removal involves transurethral piecemeal resection, which carries high recurrence (60%) and perforation (12%) rates. Although various techniques and robotic systems have been developed for en-bloc tumor resection, achieving a negative resection margin remains challenging with standard resectoscopes. Here, we present the Robot-Optimized Bladder Endoscopy Resection of Tumor (ROBERT) system, a dual-arm robotic system designed to fit into a standard irrigation sheath along with an endoscope. The ROBERT system offers enhanced dexterity and payload capacity, allowing surgeons to perform en-bloc tumor resections effectively. In both ex-vivo and in-vivo experiments, the ROBERT system achieved negative margins, with muscular tissue visually identified in the excised samples. The fastest resection was completed in approximately 6 minutes, and the largest excised tissue size was 15 ×15 × 3mm. These results demonstrate ROBERT system’s feasibility and potential for improving bladder tumor resection outcomes.
