A first-in-human trial of a robotic colonoscopy system achieved 100% cecal intubation in 50 patients, with no major adverse events, according to results of the CARE study, a prospective trial of the Triton robotic colonoscopy system.

“We proved the concept absolutely works,” said principal investigator Jason Samarasena, MD, chief of the Division of Gastroenterology and Hepatology, UC Irvine School of Medicine, who presented the data at Digestive Disease Week (DDW) 2026.

“We were able to do every single function of the colonoscope with this robot — navigation to the cecum, getting into the ileum, polyp detection, polypectomy — all of it,” he said.

Importantly, Samarasena added, the ergonomics of the device make it “a completely different experience” for the endoscopist.

Instead of standing next to the patient and pushing with the right hand and working the knobs with the left, “this is basically me sitting comfortably in a chair with a video game-type controller, relaxed and looking at a screen,” he explained.

Promising Results, Shorter Learning Curve

Unlike existing systems, which are what Samarasena calls “therapeutic robots” that assist with technically demanding tasks like large polyp removal or early cancer resection, the Triton replicates the full scope of what gastroenterologists do manually, from insertion to the cecum through polypectomy.

The single-arm, nonrandomized, single-site study evaluated the safety and efficacy of the system. Three endoscopists experienced in manual colonoscopy performed all procedures.

The study was conducted in two phases: Phase A was a lead-in phase to evaluate safety in 10 patients. This was a tandem design, with manual colonoscopy performed first, followed by robotic colonoscopy, excluding polypectomy. The primary endpoint of this phase was major adverse events, including perforation, bleeding, and hospitalization within 48 hours. Secondary endpoints were delayed perforation and/or bleeding within 14 days.

Phase B assessed safety and efficacy in 40 patients with only robotic colonoscopy, including removal of polyps < 2 cm. The main endpoints were successful completion of colonoscopy and major adverse events. Secondary endpoints included need for repositioning, adenoma detection rate (ADR), successful polypectomy, time to cecum, mucosal injury score graded from 1 to 5 (1 = erythema or bruising; 5 = full-thickness injury), and physical or mental load on the endoscopist, using the NASA task load index.

No adverse events occurred in phases A or B. Cecal intubation was achieved in 100% of cases in both phases. All procedures were completed in the left-lateral position, without the need for repositioning, abdominal pressure, or conversion to manual colonoscopy.

In phase B, 79 polyps were detected. The ADR was 54.2%, and the polyp detection rate was 67.5%.

“The rate at which we found polyps is comparable to what we would typically see with manual colonoscopy,” Samarasena noted. “We were able to remove 75 polyps in the 50 patients, which again is comparable to, if not better than, manual colonoscopy.”

All polypectomies were completed successfully; two lesions measuring > 2 cm were not removed, as per the study protocol.

The median time to the cecum was 13 minutes (range, 5-36 min). Three mucosal injuries were rated as grade 2, one was grade 3, and the rest were grade 1. None of the injuries were ≥ grade 4, and no intervention was required.

Overall, the authors wrote in their meeting abstract, the system “enabled comprehensive inspection, effective polyp detection, and safe resection while providing a comfortable ergonomic experience.”

Higher Cost, Shorter Training

In terms of potential downsides, cost is a major factor, as robotic platforms are more expensive than conventional colonoscopy systems, Samarasena acknowledged.

However, training is another variable to consider. Manual colonoscopy typically requires approximately 300 or more procedures before trainees achieve consistent cecal intubation, Samarasena said. “I think that number is going to be much, much less with this system. The learning curve is going to get so much shorter — and that’s going to be very exciting for our field.”

According to information from Neptune Medical, which produces the Triton system, the company is working through the regulatory process, he told Medscape Medical News.

Neptune Medical funded the CARE study. Samarasena is a consultant to Neptune Medical.

Marilynn Larkin, MA, is an award-winning medical writer and editor whose work has appeared in numerous publications, including Medscape Medical News and its sister publication MDedge, The Lancet (where she was a contributing editor), and Reuters Health.