Navigation Assistance Research Articles

Assistive Systems for Visually Impaired Persons: Challenges and Opportunities for Navigation Assistance.

The inability to see makes moving around very difficult for visually impaired persons. Due to their limited movement, they also struggle to protect themselves against moving and non-moving objects. Given the substantial rise in the population of those with vision impairments in recent years, there has been an increasing amount of research devoted to the development of assistive technologies. This review paper highlights the state-of-the-art assistive technology, tools, and systems for improving the daily lives of visually impaired people. Multi-modal mobility assistance solutions are also evaluated for both indoor and outdoor environments. Lastly, an analysis of several approaches is also provided, along with recommendations for the future.

Augmented reality navigation systems in endoscopy

Navigation assistance has become part of our daily lives and its implementation in medicine has been going on for the last 3 decades. Navigation is defined as the determination of a position in space in the context of its surroundings. While routing applications used in cars highlight the street to follow, in medical applications the real-world perception of the user is enriched by digital elements that provide guidance and help the user navigate. Unlike Virtual Reality (VR) solutions, which are mainly used for training, Augmented Reality systems (AR) do not require the user to wear specific headsets/goggles, but the virtual elements are overlaid over the real image displayed on a monitor. Depending on the application and the indication, there are large differences in how much these solutions have entered clinical routine. Especially in the fields of GI endoscopy and laparoscopy, AR navigation solutions are less prominently employed in clinical practice today and still hold significant potential to elevate patient care by improved physician support. This review touches upon why AR navigation systems are currently just starting to become implemented in the GI/laparoscopic clinical routine and which applications can be expected in the GI endoscopy and laparoscopy field. By taking the practitioner’s perspective and following the intuitive navigation workflow, it gives an overview of major available and potential future AR-applications in the GI endoscopy and laparoscopy space, the respective underlying technologies, their maturity level and their potential to change clinical practice.

Robotic-Assisted Versus Navigation-Assisted Posterior Lumbar Fusion : A National Database Study.

Retrospective cohort study. The aim of this study was to compare perioperative adverse events and reoperations between navigation-assisted and robotic-assisted posterior lumbar fusion. Navigation has become increasingly utilized for posterior lumbar fusion (PLF). More recently, robotic-assisted systems have been gaining traction. However, the incremental advantage of these systems has been unclear in the literature. Patients undergoing one-level to three-level PLF (with or without anterior or posterior interbody fusion) were identified from the 2015 to 2022 M161Ortho PearlDiver Database using CPT codes. Navigation assistance was identified based on CPT coding and robotic assistance was based on ICD-10 procedural coding. Navigation-assisted cases were matched 4:1 to robotic-assisted patients based on age, sex, Elixhauser Comorbidity Index, number of levels fuse, and concomitant anterior fusion. Incidence of 90-day adverse outcomes were assessed and compared with multivariable logistical regression. Bonferroni correction was applied for multiple testing. Rate of reoperation was assessed using the Kaplan-Meier survival analysis. From 2015 to 2022, there has been a significant increase in both navigation-assisted and robotic-assisted lumbar fusions, with navigation-assisted surgery being significantly more common. After matching, there were 2401 navigation-assisted cases and 651 robotic-assisted cases. On multivariate analysis, there were no significant differences in 90-day any, severe, or minor adverse events. There was a significant increase odd of readmissions in the robotic cohort (OR: 1.77, P <0.001). There were no differences in 3-year reoperation rates between the navigation-assisted and robotic-assisted cohorts (95.8% vs. 94.0%, P =0.30). As spinal navigation has been gaining popularity and robotic assistance is starting to be further utilized, the incremental advantage of different techniques may be questioned. While further study and technique evolution are ongoing, the current study was not able to demonstrate 90-day or 3-year incremental advantages for robotics relative to navigation based on the metrics evaluated. Level III.

Computer Vision-Based Mobile Application for Visually Impaired

In our society, there's a growing need for awareness and support, especially for individuals facing visual impairments. This endeavor revolves around creating a specialized mobile application precisely catering to their unique needs. Harnessing the capabilities of computer vision and deep learning, the app functions as a versatile aid, offering real-time support and enhancing accessibility for its users. Through the Smartphone’s camera, the application can identify and describe various objects, allowing users to gain a better understanding of their immediate environment. Furthermore, the integration of optical character recognition (OCR) technology enables the app to convert printed text into audio, providing users with access to a wide range of printed materials. The navigation assistance feature utilizes advanced algorithms to detect obstacles and provide users with alerts, ensuring safe and efficient navigation.

Development of a combined harvester navigation control system based on visual simultaneous localization and mapping-inertial guidance fusion

Recently, the existing unmanned systems of combine harvesters mostly adopts satellite navigation scheme, lacking real-time observation of harvesting adjustment. To improve the operational efficiency of combine harvester assisted navigation operation, this paper designs a combine harvester navigation control system based on vision simultaneous localization and mapping (SLAM)-inertial guidance fusion. The system acquires field image information and extracts the crop boundary line as the navigation datum by binocular camera. First, the system acquires field image information through binocular camera and extracts the crop boundary line as the navigation datum. Second, fusing camera and inertial guidance information to obtain the real-time relative position of a combine harvester. Third, constrained optimization of image and inertial guidance information is achieved through a sliding window optimization method based on tightly coupled nonlinear optimization. Finally, obtain the position of the combine harvester relative to the navigation datum line, and output a signal to the steering mechanism to realize the combine harvester in the field intelligent positioning navigation control. The system consists of binocular camera, inertial measurement unit, motorized steering wheel, monitor display, angle sensor and microcontroller. During field testing, the system underwent repetitive harvesting trials over a distance of 25 m.. The testing machine performs field operations at a speed of 0.9-1.5 m/s, with an average lateral deviation range of 2.21-8.62 cm, a standard deviation range of 0.13-4.21 cm and an average cutting rate range of 92.2%-96.0%, achieving the expected harvesting effect.

High-performance textile-based triboelectric nanogenerators with damage insensitivity and shape tailorability

Textile-based triboelectric nanogenerators (TENGs) represent a groundbreaking advancement in the field of wearable technology for supplying sustainable energy. In this study, a knitted dual-faced textile-based TENGs was proposed to address the existing challenges of low energy output and poor wearability. The fabric, composed of polytetrafluoroethylene (PTFE) yarn and silver-plated yarn, features a unique intermeshed structure that enhances the corresponding TENG's output performance by increasing the contact area between the tribo-material and electrode. Such textile-based TENG have demonstrated an ability to attain open-circuit voltage, short-circuit current, and power density up to 133.8 V, 21.9 μA, and 0.53 W/m2, respectively. More importantly, the dual-faced triboelectric fabric exhibited exceptional damage insensitivity and shape tailorability, making it sustainable for long-term use in wearable devices. The textile-based TENG can power various microelectronic devices, including LED arrays and calculators, showcasing their potential as reliable energy sources for wearable electronics. Furthermore, a real-time wireless direction indication system integrated into a smart garment was developed, demonstrating the TENG's versatility in applications beyond energy harvesting, potentially in navigation assistance. The advent of the dual-faced triboelectric fabric signifies an important step forward in wearable technology, promising enhanced performance and expanded applications in both energy collection and sensing technology.

Multi-Agent Cooperative Camera-Based Semantic Grid Generation

The idea of cooperative perception for navigation assistance was introduced about a decade ago with the aim to increase safety on dangerous areas like intersections. In this context, roadside infrastructure appeared very recently to provide a new point of view of the scene. In this paper, we propose to combine the Vehicle-To-Vehicle (V2V) and Vehicle-To-Infrastructure (V2I) approaches in order to take advantage of the elevated points of view offered by the infrastructure and the in-scene points of view offered by the vehicles to build a semantic grid map of the moving elements in the scene. To create this map, we chose to use camera information and 2-Dimentional (2D) bounding boxes in order to minimize the impact on the network and ignored possible depth information as opposed to all state-of-the art methods. We propose a framework based on two fusion methods: one based on the Bayesian theory and the other on the Dempster-Shafer Theory (DST) to merge the information and chose a label for each cell of the semantic grid in order to assess the best fusion method. Finally, we evaluate our approach on a set of datasets that we generated from the CARLA simulator varying the proportion of Connected Vehicle (CV) and the traffic density. We also show the superiority of the method based on the DST with a gain on the mean intersection over union between the two methods of up to 23.35%.

The Construction of Tour Guide Application to Enhancement and Multilingual Tourism Development in Mahasarakham Province, THAILAND

This study investigates the development and efficacy of a multilingual tourism application designed to enhance tourism development in Mahasarakham Province, Thailand, focusing particularly on its utility for foreign students due to the region&amp;rsquo;s educational allure and cultural heritage. The application features a comprehensive suite of services, including weather information, personalized travel recommendations, navigational assistance, and detailed local guides covering dining, healthcare, lodging, cultural practices, and historical insights, thereby distinguishing it from conventional tourism apps. The results of the study reveal significant outcomes. Expert evaluations yielded a Content Validity ratio (Content validity) of 0.86, indicating high relevance and accuracy of the app&amp;rsquo;s content. The application&amp;rsquo;s Reliability stood at 0.91, reflecting its consistency and dependability. Additionally, the Objectivity score was 0.80, suggesting the app&amp;rsquo;s impartiality and fairness in presenting information. These results affirm the application&amp;rsquo;s effectiveness in providing a reliable, accurate, and user-friendly resource for enhancing tourists&amp;rsquo; experiences while promoting cultural understanding and economic development within Mahasarakham Province.

Understanding the financial cost of cancer clinical trial participation.

Though financial hardship is a well-documented adverse effect of standard-of-care cancer treatment, little is known about out-of-pocket costs and their impact on patients participating in cancer clinical trials. This study explored the financial effects of cancer clinical trial participation. This cross-sectional analysis used survey data collected in December 2022 and May 2023 from individuals with cancer previously served by Patient Advocate Foundation, a nonprofit organization providing social needs navigation and financial assistance to US adults with a chronic illness. Surveys included questions on cancer clinical trial participation, trial-related financial hardship, and sociodemographic data. Descriptive and bivariate analyses were conducted using Cramer's V to estimate the in-sample magnitude of association. Associations between trial-related financial hardship and sociodemographics were estimated using adjusted relative risks (aRR) and corresponding 95% confidence intervals (CI) from modified Poisson regression models with robust standard errors. Of 650 survey respondents, 18% (N = 118) reported ever participating in a cancer clinical trial. Of those, 47% (n = 55) reported financial hardship as a result of their trial participation. Respondents reporting trial-related financial hardship were more often unemployed or disabled (58% vs. 43%; V = 0.15), Medicare enrolled (53% vs. 40%; V = 0.15), and traveled >1 h to their cancer provider (45% vs. 17%; V = 0.33) compared to respondents reporting no hardship. Respondents who experienced trial-related financial hardship most often reported expenses from travel (reported by 71% of respondents), medical bills (58%), dining out (40%), or housing needs (40%). Modeling results indicated that respondents traveling >1 h vs. ≤30 min to their cancer provider had a 2.2× higher risk of financial hardship, even after adjusting for respondent race, income, employment, and insurance status (aRR = 2.2, 95% CI 1.3-3.8). Most respondents (53%) reported needing $200-$1000 per month to compensate for trial-related expenses. Over half (51%) of respondents reported less willingness to participate in future clinical trials due to incurred financial hardship. Notably, of patients who did not participate in a cancer clinical trial (n = 532), 13% declined participation due to cost. Cancer clinical trial-related financial hardship, most often stemming from travel expenses, affected almost half of trial-enrolled patients. Interventions are needed to reduce adverse financial participation effects and potentially improve cancer clinical trial participation.

DRAGON: A Dialogue-Based Robot for Assistive Navigation With Visual Language Grounding

DRAGON: A Dialogue-Based Robot for Assistive Navigation With Visual Language Grounding

Financial-legal navigation reduces financial toxicity of pediatric, adolescent, and young adult cancers.

Pediatric, adolescent, and young adult patients with cancer and their caregivers are at high risk of financial toxicity, and few evidence-based oncology financial and legal navigation programs exist to address it. We tested the feasibility, acceptability, and preliminary effectiveness of Financial and Insurance Navigation Assistance, a novel interdisciplinary financial and legal navigation intervention for pediatric, adolescent and young adult patients and their caregivers. We used a single-arm feasibility and acceptability trial design in a pediatric hematology and oncology clinic and collected preintervention and postintervention surveys to assess changes in financial toxicity (3 domains:psychological response/Comprehensive Score for Financial Toxicity [COST], material conditions, and coping behaviors); health-related quality of life (Patient-Reported Outcomes Measurement Information System Physical and Mental Health, Anxiety, Depression, and Parent Proxy scales); and perceived feasibility, acceptability, and appropriateness. In total, 45 participants received financial navigation, 6 received legal navigation, and 10 received both. Among 15 adult patients, significant improvements in FACIT-COST (P = .041) and physical health (P = .036) were noted. Among 46 caregivers, significant improvements were noted for FACIT-COST (P < .001), the total financial toxicity score (P = .001), and the parent proxy global health score (P = .0037). We were able to secure roughly $335 323 in financial benefits for 48 participants. The intervention was rated highly for feasibility, acceptability, and appropriateness. Integrating financial and legal navigation through Financial and Insurance Navigation Assistance was feasible and acceptable and underscores the benefit of a multidisciplinary approach to addressing financial toxicity. NCT05876325.

Fixation-related potentials during mobile map assisted navigation in the real world: The effect of landmark visualization style.

An often-proposed enhancement for mobile maps to aid assisted navigation is the presentation of landmark information, yet understanding of the manner in which they should be displayed is limited. In this study, we investigated whether the visualization of landmarks as 3D map symbols with either an abstract or realistic style influenced the subsequent processing of those landmarks during route navigation. We utilized a real-world mobile electroencephalography approach to this question by combining several tools developed to overcome the challenges typically encountered in real-world neuroscience research. We coregistered eye-movement and EEG recordings from 45 participants as they navigated through a real-world environment using a mobile map. Analyses of fixation event-related potentials revealed that the amplitude of the parietal P200 component was enhanced when participants fixated landmarks in the real world that were visualized on the mobile map in a realistic style, and that frontal P200 latencies were prolonged for landmarks depicted in either a realistic or abstract style compared with features of the environment that were not presented on the map, but only for the male participants. In contrast, we did not observe any significant effects of landmark visualization style on visual P1-N1 peaks or the parietal late positive component. Overall, the findings indicate that the cognitive matching process between landmarks seen in the environment and those previously seen on a map is facilitated by more realistic map display, while low-level perceptual processing of landmarks and recall of associated information are unaffected by map visualization style.

On the data-driven investigation of factors affecting the need for icebreaker assistance in ice-covered waters

Merchant vessels often require icebreaker (IB) assistance to create safe pathways and improve efficiency when navigating in the Baltic Sea. Since IB resources are limited, an accurate estimation on the need for IB assistance is important. Whether IB assistance is needed depends on multiple factors. While practical experience from captains is naturally a source of valuable information for the decision on the need for IB assistance, systematic analysis of the reasoning is limited. The primary aim of this paper is to holistically investigate the influencing factors and their effect on estimating the need for IB assistance through data-driven techniques. Based on a comprehensive list of potential factors, different of data such as traffic history, environmental conditions, and ship specifications are gathered to present complex navigational scenarios. Each scenario is labeled by different navigation modes (independent navigation or IB assistance), laying the foundation for influencing factor identification and effect quantification. Logistic regression is applied to evaluate the effect of the factors on the need for IB assistance. The results show that the impact of the factors is diverse, and ridged ice concentration has the most significant impact. The effectiveness of identified factors is measured by comparing it to that of the factors that have been implemented by the existing studies (e.g., the combination of ice concentration, thickness, and ship ice class, or only ship speed). By considering the factors in this study, the classification performance can be improved by at least 5.6%. The findings in this paper can provide insights for predicting IB workloads and optimizing IB resources and have the potential to support the development of an intelligent decision-support system for winter navigation.

Underwater target recognition algorithm based on improved convolutional neural network: YOLOV5-Improved

This paper proposes an underwater identification method based on the YOLOV5-Improved model. The MobileOne module is added to the Backbone network of the previous model to improve the lightweight model and reduce the network complexity. The amount of parameters, the amount of calculation, and the inference time; the CA full-dimensional dynamic convolution module is embedded in the MP module of the previous model to focus on the main features, and better focus on the discriminative features of fishing nets, thereby improving the accuracy of fishing net recognition; in The adaptive spatial feature fusion module ASFF is introduced into the head network of the previous model to perform multi-scale feature fusion and remove useless background information to improve the detection and mining capabilities of smaller targets in complex backgrounds under natural conditions. The final experiment proved that the YOLOV5-Improved model has a good learning effect and faster convergence speed during the training process, and the experimental accuracy can reach 99.6%, which can better detect underwater fishing nets and provide assistance for safe navigation at sea.

Implementation of Smart Hindrance Tracking System

The Smart Hindrance Tracking System for Blind Individuals is a mini-project aimed at enhancing the mobility and safety of visually impaired individuals in navigating their surroundings. Leveraging cutting-edge technologies, this system integrates computer vision, sensor networks, and mobile applications to provide real-time hindrance detection and navigation assistance. The primary objective is to empower blind individuals with a reliable and intelligent solution that enables them to identify and navigate around obstacles in their path. The system utilizes a combination of depth-sensing cameras and ultrasonic sensors to detect obstacles in the user's vicinity. These sensors feed data to a central processing unit, where a computer vision algorithm processes the information in real-time, identifying obstacles and their spatial locations. The processed data is then communicated to the user through a user-friendly mobile application. This research presents the daily challenges faced by visually impaired individuals but also fosters inclusivity and independence. The Smart Hindrance Tracking System stands at the intersection of technology and social impact, offering an innovative solution to improve the lives of those with visual impairments.

Pedicle screw accuracy placed with assistance of machine vision technology in patients with neuromuscular scoliosis.

Pedicle screws are the primary method of vertebral fixation in scoliosis surgery, but there are lingering concerns over potential malposition. The rates of pedicle screw malposition in pediatric spine surgery vary from 10% to 21%. Malpositioned screws can lead to potentially catastrophic neurological, vascular, and visceral complications. Pedicle screw positioning in patients with neuromuscular scoliosis is challenging due to a combination of large curves, complex pelvic anatomy, and osteopenia. This study aimed to determine the rate of pedicle screw malposition, associated complications, and subsequent revision from screws placed with the assistance of machine vision navigation technology in patients with neuromuscular scoliosis undergoing posterior instrumentation and fusion. A retrospective analysis of the records of patients with neuromuscular scoliosis who underwent thoracolumbar pedicle screw insertion with the assistance of machine-vision image guidance navigation was performed. Screws were inserted by either a staff surgeon, orthopaedic fellow, or orthopaedic resident. Post-operative ultra-low dose CT scans were used to assess pedicle screw accuracy. The Gertzbein classification was used to grade any pedicle breaches (grade 0, no breach; grade 1, <2 mm; grade 2, 2-4 mm; grade 3, >4 mm). A screw was deemed accurate if no breach was identified (grade 0). 25 patients were included in the analysis, with a mean age of 13.6 years (range 11 to 18 years; 13/25 (52.0%) were female. The average pre-operative supine Cobb angle was 90.0 degrees (48-120 degrees). A total of 687 screws from 25 patients were analyzed (402 thoracic, 241 lumbosacral, 44 S2 alar-iliac (S2AI) screws). Surgical trainees (fellows and orthopaedic residents) inserted 46.6% (320/687) of screws with 98.8% (4/320) accuracy. The overall accuracy of pedicle screw insertion was 98.0% (Grade 0, no breach). All 13 breaches that occurred in the thoracic and lumbar screws were Grade 1. Of the 44 S2AI screws placed, one screw had a Grade 3 breach (2.3%) noted on intra-operative radiographs following rod placement and correction. This screw was subsequently revised. None of the breaches resulted in neuromonitoring changes, vessel, or visceral injuries. Machine vision navigation technology combined with careful free-hand pedicle screw insertion techniques demonstrated high levels of pedicle screw insertion accuracy, even in patients with challenging anatomy.

Stereotactic Navigation-Assisted Laparoscopic Resection of Challenging Low Pelvic Tumors: A Case Series.

(1) Introduction: The laparoscopic approach to low pelvic tumors is challenging and hindered by suboptimal tumor visualization and dissection, with possible oncological failure. Stereotactic navigation provides real-time image guidance that may optimize safety, accuracy, and precision when dissecting challenging low pelvic tumors. (2) Methods: Preoperative CT images were acquired with eight skin-fixed fiducials and loaded into a navigation system. A patient tracker was mounted on the bed side. Patient-to-image paired point registration was performed, and an instrument tracker was mounted on a laparoscopic instrument and calibrated for instrument tracking. Surgical operations were performed with real-time stereotactic navigation assistance. (3) Results: Three patients underwent stereotactic navigation surgery. Fiducial registration errors were good to optimal (±1.9, ±3.4, and ±3.4 mm). Lesions were easily identified and targeted with real-time navigation. Surgeries were uneventful. Histopathology examinations identified one retro-rectal schwannoma, one lateral pelvic recurrence from rectal adenocarcinoma, and one advanced anal canal carcinoma. No navigation-related complications, readmissions, or postoperative mortalities were observed. (4) Conclusions: The application of laparoscopic stereotactic navigation surgery to complex low pelvic tumors is feasible and could impact oncological surgical quality by enabling tumor targeting and ensuring resection margins. Further wider series are needed to confirm stereotactic navigation's impact on challenging low pelvic tumors.

The difficult PICC insertion is associated with the significant increase of complications in 1 month follow-up

Background: PICC is routinely inserted with assistance of ultrasonography and/or ECG navigation (RI- routine insertion). Only in a minority of patients the insertion of a PICC is difficult and fluoroscopic visualization with introduction of special guidewire is necessary for the success of the procedure (DI-difficult insertion). The aim of the study was to evaluate whether DI can be predicted and associated with a risk of complications during follow-up. Methods: The study included patients who had a PICC insertion in 2022. The number of patients with RI and DI was recorded and the significance of selected parameters during insertion and the frequency of complications during 1 month follow-up was compared. Results: About 1404 patients had successful PICC insertion in 2022, RI in 1360 (96.8%) and DI in 44 patients (3.2%). There was no significant effect of age, gender, selected vein, its size, insertion site, and tunneling on the course of PICC insertion. However the number of punctures for needle insertion was higher in DI. The complication rate during 1 month follow-up in DI was 9 (20.4%) versus 101 patients (7.4%) in RI ( p = 0.002). Conclusion: PICC insertion was successful in both RI and DI patients. Of the analyzed parameters, the number of needle punctures was associated with DI, and complications during the 1-month follow-up were more frequently noted in the DI group.

Robotics and Navigation Do Not Affect the Risk of Periprosthetic Joint Infection Following Primary Total Hip Arthroplasty: A Propensity Score-Matched Cohort Analysis.

The use of computer navigation or robotic assistance during primary total hip arthroplasty (THA) has yielded numerous benefits due to more accurate component positioning. The utilization of these tools is generally associated with longer operative times and also necessitates additional surgical equipment and personnel in the operating room. Thus, the aim of this study was to evaluate the impact of technology assistance on periprosthetic joint infection (PJI) after primary THA. We retrospectively reviewed the records for 12,726 patients who had undergone primary THA at a single high-volume institution between 2018 and 2021. Patients were stratified by surgical technique (conventional THA, computer-navigated THA [CN-THA], or robotic-assisted THA [RA-THA]) and were matched 1:1 with use of propensity score matching. Univariate and logistic regression analyses were performed to compare the rates of PJI within 90 days postoperatively between the cohorts. After propensity score matching, there were 4,006 patients in the THA versus RA-THA analysis (2,003 in each group) and 5,288 patients in the THA versus CN-THA analysis (2,644 in each group). CN-THA (p < 0.001) and RA-THA (p < 0.001) were associated with longer operative times compared with conventional THA by 3 and 11 minutes, respectively. The rates of PJI after conventional THA (0.2% to 0.4%) were similar to those after CN-THA (0.4%) and RA-THA (0.4%). On the basis of logistic regression, the development of PJI was not associated with the use of computer navigation (odds ratio [OR], 1.8 [95% confidence interval (CI), 0.7 to 5.3]; p = 0.232) or robotic assistance (OR, 0.9 [95% CI, 0.3 to 2.3]; p = 0.808). Despite longer operative times associated with the use of computer navigation and robotic assistance, the use of these tools was not associated with an increased risk of PJI within 90 days after surgery. Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.

Endoluminal and next generation robotics in colorectal surgery

Innovative approaches leverage cutting-edge technologies to advance the field of minimally invasive colorectal surgery. The implementation of complex endoluminal and transluminal procedures is challenging and requires extensive training. Recent technological advances not only enable improved detection of colorectal neoplasms with the support of computer science, but also enhanced surgical treatment with robotic instrumentation. Early diagnosis will revolutionize colorectal cancer treatment by avoiding surgery, as has been demonstrated in the treatment of early-stage gastric cancer using third-space endoscopy. Automated colorectal cancer screening with polyp detection and classification can change the therapeutic strategy and orient towards resection during endoscopy, including full-thickness resection, with endoscopic bimanual suturing to close the defect. Several therapeutic flexible endoscopic robotic systems are expected to provide surgery-like dexterity for endo- and transluminal approaches by enabling tissue triangulation while lowering the technical hurdles for endoscopic submucosal dissection and other highly sophisticated procedures such as endoscopic creation or revision of anastomoses. In the curvilinear anatomy of the colon and rectum, navigation assistance for improved spatio-temporal orientation will aid in the detection and documentation of lesions and facilitate their localization for excision and follow-up. Flexible robotic systems encourage surgeons as well as gastroenterologists to perform advanced intra- and transluminal resections.