2026 Endoluminal Robotics Predictions

I think wave one of surgical robotics is coming to an end. NO I don't mean that we have finished with da Vinci systems etc. But surgical multiport robots being novel - or just toys - is over and they have firmly passed a tipping point and have entered into the main stream of surgery. Last year robotic surgery surpassed open surgery or laparoscopic surgery in the USA. That was a landmark moment - and there is no going back.

But with over 36 robots out there of various formats - it's an estbalished and crowded space. Still super exciting - lots of future in it and do see my other video on predictions for 2026.

Today I'm digging into the "next wave" of where surgical robotics is heading. And that is endoluminal robotics. These are robots that enter some form of natural opening (orifice) in the body and go down a natural tract. That can be going doen through the mouth and down the oesophagus into the stomach. It could be through the airways into the lung.

One caution - don't think all endoluminal robots are long flexible robots - there are plenty of short rigid endoluminal robots.

I've attached my full video on my predictions for 2026 - but want to give some supplemental information.

In the video I talk about 3 main areas (it is not limited to those as a disclaimer.) 1) Endobronchial robotics - robots through the mouth - down to the lungs to do diagnostics - biopsy and or treat a leasion. Robotically.

2) Endourological robotics - through the urethra to the bladder - and you can stop there (like Virtuoso) or you can carry on up the Ureter to the kidney and do things in the uereters or in the kidney via the robot. Such as PCNL - (watch the video.)

3) EndoGI - robotics - robots that go into the GI tract via the mouth or the anus. I want to add a few Notes (pun intended) there are also a few robots that are using the vagina as the entry point - and if they stay inside the uterus - this is hysteroscopy - and if you do it with a robot you are technically Endoluminal (I'm not covering that today.) With vNotes - you use the vagina as entry but go out of the lumen trans mural. This becomes technically a NOTES procedure. I want to stress that later this year I will discuss endoluminal robots that don't stay inside the tract - but venture out as transmural robots - but that is for another day. We will discuss that as Full Thickness Resections - transmural approaches and NOTES (Natural Oriifice Transluminal Endoscopic Surgery.) I am not focused too much there today. No you see my pun.... ohhhhhh.

I also want to add here (as I mention it in the video and don't dwell too deeply) I'd like you augment some information on energy application via bronchoscopic robots today into see n treat. As I made the video there was an announcement by ENDOWAVE - a company from Ireland that puts Microwaves down a long flexible catheter to deliver energy to ablate tissue.

This system has just entered recent clinical trials in conjunction with the current leading endobronchial robot ION by Intuitive. This is not the first microwave used with a bronchial robot. NueWave (flex) by Johnson & Johnson - was in trials with their Monarch system. They had the POWER study that finished in 2024 in the USA ablating Lung Neoplasms (12 patients.)

I did do a post on some of this - you have Microwave - RF - Cryo and others to thermally destroy tissue. There are PEF devices Pulsed Electric Fields (Galvanize Therapeutics) and more and more on the way.

My message is to see this next wave already under way inrobotics - being led by the lung. And it is here that we start to see the benefit of the robots - Guidance - simplified repeatable delivery - stability and targeting. Themes that I will cover in the coming months in details in posts and videos. I wanted to add this information as some viewers of the video didn't quite get the energy delivery and why that allows see n treat - so I've expanded a little more. It allows you to diagnose - and treat in one sitting - 1 session. BUT also allow longitudinal rpeated ablations by having the same navigation take you back to the sam spot in repeated sessions. With all that said - on with the video. It is the same as Youtube so if you've seen it - watch again with these extra small bits of info..

Again all speculation and for education purposes only.