Researchers have created a new magnetic-controlled capsule device that can "drive" the stomach with a joystick to take images of areas of interest to medical personnel. It's not like other endoscopy cameras that rely on the natural movement of the gut and gravity to move. Traditional endoscopy uses a long, thin, flexible tube with a video camera on the end that passes through the mouth and into the upper digestive tract. The procedure is used to investigate the cause of stomach pain, nausea, bleeding and weight loss. In the United States, more than 7 million endoscopies are performed each year.
Capsule endoscopy using a "pill camera," which involves swallowing a capsule containing a camera and taking images of the digestive tract, is much less invasive than traditional endoscopy and has been in use since the early 2000s. However, there are limits to what a pill CAM can see. They rely on the natural movement of the gut and gravity to move through the gastrointestinal tract and cannot be guided to specific areas of the stomach.
Now, researchers from George Washington University have developed a new type of capsule endoscope that uses magnets to control the device's movement through the body. Their study is the first in the United States to investigate the feasibility of magnetic-controlled capsule endoscopy (MCCE) visualizing the human stomach.
"Traditional endoscopy is an invasive procedure for patients, not to mention expensive due to the need for anesthesia and downtime," said Andrew Meltzer, lead author of the study.
Meltzer was motivated to create NaviCam MCCE after treating patients who came to the emergency room with potentially life-threatening stomach problems.
The researchers tested MCCE on 40 adult patients who needed an endoscopy as part of a standard assessment of their symptoms. Patients must have one or more surgical indications, including stomach pain, bloating, heartburn, nausea and/or vomiting, anemia, or weight loss.
Patients are asked to stop eating after 8 p.m. the day before surgery. On the day of surgery, the patient drank four 8-ounce (1-liter) glasses of water containing simethicone, an antifoam agent that reduces gas in the stomach. About 10 minutes after drinking the last glass of water, the patient was asked to swallow the capsule. The patient then lies on a table with a magnet on it and wears a data recording vest.
A study volunteer on an operating table wears a data-recording vest with magnets above his chest at George Washington University.
Doctors who perform MCCE control the capsule using a pair of joysticks, like those used when playing video games. One controls the movement of the capsule along the X-Y-Z axis, and the other controls the rotation along the horizontal or vertical axis.
NaviCam, created by AnX Robotica, offers a 160-degree field of view and delivers continuous video with a resolution of 640 x 480 pixels per inch through a single camera at a frame rate of 0.5 to 6 frames per second.
The researchers found that the magneto capsule was able to observe all anatomical areas of the stomach and record video and still images of bleeding, inflammation or malignant lesions with a 95 percent visibility rate. If there is no gastroenterologist at the clinic where the procedure is performed, the video can be transmitted directly off-site for review by the gastroenterologist.
Patients underwent traditional endoscopy after MCCE to compare results. The researchers found that the new method did not miss any high-risk lesions, and 80 percent of patients preferred to use NaviCam instead of traditional methods.
While doctors using NaviCam need to be trained in how to use the joystick, researchers are developing software that uses artificial intelligence to drive the capsule itself to all parts of the stomach and record abnormalities.
The researchers plan to use NaviCam on a larger sample group to ensure the accuracy of their diagnosis. They recognized that the disadvantage of MCCE is the inability to biopsy the lesions in question, which can be done with traditional endoscopy. However, the researchers envision that NaviCam will become a first-line method for diagnosing stomach problems, with biopsies performed by traditional means only when needed.
"MCCE in alternative Settings such as emergency departments, urgent care, and primary care could conceivably be a cost-effective way to assess GI[gastrointestinal] symptoms in an outpatient setting," the researchers said. MCCE may be particularly cost-effective if it reduces hospital admissions, the need for anesthesia, and missed working days."
The study is in the journal iGIE. In the following video produced by George Washington University, Andrew Meltzer, lead author of the study, talks about why the magnetron capsule was developed and how it works.
