Robotic‐Assisted Bile Duct Cannulation During Endoscopic Retrograde Cholangiopancreatography: A Randomised Controlled Crossover Animal Study

ABSTRACT Introduction Endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging, with high operator radiation exposure, physical strain, and a steep learning curve, necessitating a robotic solution. This study evaluated robotic‐assisted ERCP feasibility and efficacy in an animal model. Methods In this randomised controlled crossover study, three experienced endoscopists performed 24 ERCP procedures (12 robotic‐assisted vs. 12 manual) on four beagles using the YunSRobot system. Primary outcomes included papilla positioning maintenance, cannulation time, and success rate. Results Robotic‐assisted ERCP demonstrated superior papilla positioning (95.74% vs. 77.25%, p < 0.01), indicating more endoscopic stability during cannulation. The successful cannulation rate was identical in both groups (83.3%). The robotic group required fewer attempts (2.0 vs. 3.5) and experienced no scope dislocations (0 vs. 5). No severe adverse events occurred in either group. Conclusions Robotic‐assisted ERCP is feasible, safe, and effective, offering significantly improved endoscopic stability with comparable cannulation success to manual techniques.