While ingestible video capsule endoscopes have been around for many years, the capsules
have been limited by the fact that they could not be controlled by physicians.
They moved passively, driven only by gravity and the natural movement of the body.
Now, according to a first-of-its-kind research study at George Washington University, physicians
can remotely drive a miniature video capsule to all regions of the stomach to visualize
and photograph potential problem areas.
The new technology uses an external magnet and hand-held video game style joysticks to
move the capsule in three-dimensions in the stomach.
This new technology comes closer to the capabilities of a traditional tube-based endoscopy.
A traditional endoscopy is an invasive procedure for patients, not to mention it is costly
due to the need for anesthesia and time off work.
If larger studies can prove this method is sufficiently sensitive to detect high-risk
lesions, magnetically controlled capsules could be used as a quick and easy way to screen
for health problems in the upper GI tract such as ulcers or stomach cancer.
More than 7 million traditional endoscopies of the stomach and upper part of the intestine
are performed every year in the United States to help doctors investigate and treat stomach
pain, nausea, bleeding and other symptoms of disease, including cancer.
Despite the benefits of traditional endoscopies, studies suggest some patients have trouble
accessing the procedure.
In fact, the researcher got interested in the magnetically controlled capsule endoscopy
after seeing patients in the emergency room with stomach pain or suspected upper GI bleeding
who faced barriers to getting a traditional endoscopy as an outpatient.
The study is the first to test magnetically controlled capsule endoscopy in the United
States.
For patients who come to the ER or a doctor’s office with severe stomach pain, the ability
to swallow a capsule and get a diagnosis on the spot – without a second appointment
for a traditional endoscopy – is a real plus, not to mention potentially life-saving.
An external magnet allows the capsule to be painlessly driven to visualize all anatomic
areas of the stomach and record video and photograph any possible bleeding, inflammatory
or malignant lesions.
While using the joystick requires additional time and training, software is being developed
that will use artificial intelligence to self-drive the capsule to all parts of the stomach with
a push of the button and record any potential risky abnormalities.
That would make it easier to use the system as a diagnostic tool or screening test.
In addition, the videos can be easily transmitted for off-site review if a gastroenterologist
is not on-site to over-read the images.
The researchers conducted a study of 40 patients at a physician office building using the magnetically
controlled capsule endoscopy.
They found that the doctor could direct the capsule to all major parts of the stomach
with a 95 percent rate of visualization.
Capsules were driven by the ER physician and then the study reports were reviewed by an
attending gastroenterologist who was physically off-site.
To see how the new method compared with a traditional endoscopy, participants in the
study also received a follow up endoscopy.
No high-risk lesions were missed with the new method and 80 percent of the patients
preferred the capsule method to the traditional endoscopy.
The team found no safety problems associated with the new method.
Yet, the researcher cautions that the study is a pilot and a much bigger trial with more
patients must be conducted to make sure the method does not miss important lesions and
can be used in place of an endoscopy.
A major limitation of the capsule includes the inability to perform biopsies of lesions
that are detected.
The medical technology company AnX Robotica funded the research and is the creator of
the capsule endoscopy system used in the study, called NaviCam®.