Code

AIONS

AI-based operative navigation for endoscopic submucosal dissection

Guankun Wang1,2†Jingran Su3†Huxin Gao1†Yibo Zhang3†Qi Tang4†Rui Tang1Yiling Li5Long Bai1Mingliang Feng5Bowen Li5Lisheng Wang4Jiazheng Wang2Xiuli Zuo3Zhen Li3*Hongliang Ren1*

  1. 1Department of Electronic Engineering, The Chinese University of Hong Kong
  2. 2Theory Lab, Central Research Institute, 2012 Labs, Huawei Technologies Co. Ltd.
  3. 3Department of Gastroenterology, Qilu Hospital of Shandong University
  4. 4Department of Gastroenterology, Shenzhen People’s Hospital
  5. 5Department of Endoscopy, The First Hospital of China Medical University

01Motivation

Where to dissect next?

A surgeon asks where to dissect next while identifying the mucosa, submucosa, vessels and muscularis, aiming to avoid vessels and the muscular layer.
Original endoscopic frame before AIONS guidance
The same endoscopic frame with the AIONS-predicted dissection trajectory in yellow

AIONS uses the endoscopic image to predict a dissection trajectory, providing a visible path reference for the surgeon.

02THE DATASET

ESD Dissection Trajectory Dataset

Dataset composition: 84 patients, 3 hospitals, 10 surgical sites, 62.16 hours of raw video and 13,052 images, with operation time and image count for each case.
Anatomical map of ten ESD sites across the oesophagus, stomach and colorectum
Centre-specific distributions of the dataset

Upper esophagus

03EXPERIMENTAL SETUP

The comprehensive step-wise study

The comprehensive step-wise study design

Prospective experiment settings of AIONS

System workflow: gastrointestinal tract, endoscope, endoscopy processor, Olympus screen, AIONS, AI screen and eye tracker.
Pre-clinical animal setting
Pre-clinical animal setting, with numbered devices from the system workflow.
Clinical setting
Clinical setting, with numbered devices from the system workflow.

04EXPERIMENTAL DEMONSTRATION

Convertional ESD

Pre-clinical ESD

Live-porcine study
Study video
Endoscopic view

Clinical ESD

Human study
Study photograph (Clinical environment Demo is not permitted for public release by the IRBs.)
Clinical ESD deployment in the operating room
Endoscopic view

Robotic ESD

AIONS desktop navigation software, a porcine stomach model and an operator using the dual-arm robotic teleoperation system.

AIONS provides a predicted trajectory for dual-arm robotic teleoperation in an ex vivo porcine stomach model, following a prediction–lock–execution workflow.

Robotic operation
Endoscopic view

↗THE RESEARCH

AI-based operative navigation for endoscopic submucosal dissection

Guankun Wang et al. · 2026