Remotely-Driven Ingestible Video Capsule Could Offer Alternative to Invasive Endoscopy

By HospiMedica International staff writers
Posted on 02 Jun 2023

Image: The NaviCam capsule endoscopy system used in the study (Photo courtesy of AnX Robotica)

Across the world, doctors perform millions of traditional endoscopies every year to diagnose and treat symptoms of diseases such as stomach pain, nausea, bleeding, and cancer in the stomach and upper part of the intestine. However, access to this procedure remains a challenge for some patients. The medical industry has been employing ingestible video capsule endoscopes for some time now, but these capsules have been limited by their lack of controllability, moving solely due to gravity and natural body movements. A groundbreaking study has demonstrated that physicians can remotely navigate a miniaturized video capsule through the stomach, providing a comprehensive visualization and photographic documentation of potential problem areas. This innovative technology employs an external magnet and a joystick resembling video game controls to steer the capsule in three dimensions within the stomach, significantly improving its diagnostic capabilities.

The study by physicians at George Washington University (Washington, DC, USA) is the first to test magnetically controlled capsule endoscopy in the United States. The research was funded by medical technology company AnX Robotica (Plano, TX, USA) which is the creator of the capsule endoscopy system used in the study, called NaviCam. The technology enables patients with severe stomach pain to get an instant diagnosis without needing a follow-up appointment for a traditional endoscopy – a potentially lifesaving feature. The capsule, driven by an external magnet, painlessly navigates through all areas of the stomach, recording videos and capturing images of any possible bleeding, inflammatory, or malignant lesions. While the joystick operation requires additional training, software is being developed that utilizes artificial intelligence for automatic navigation of the capsule throughout the stomach with a simple button push. This will allow recording of any possible high-risk abnormalities, making the system more user-friendly and efficient as a diagnostic tool or screening test. The system also enables easy transmission of the captured videos for remote analysis when a gastroenterologist isn't available to review the images on-site.

The research involved a study of 40 patients at a physician office building using the magnetically controlled capsule endoscopy. The results demonstrated a 95% success rate in visualizing all major parts of the stomach. An ER physician operated the capsules, after which the reports were reviewed by an off-site gastroenterologist. When compared with traditional endoscopy, the new method missed no high-risk lesions, and 80% of the patients preferred this approach over the conventional endoscopy. No safety issues were observed with the use of the new method, according to the research team. However, the researchers have cautioned that this was a pilot study, and a larger trial with more patients is required to confirm the method's reliability and its potential to replace endoscopy. The study also pointed out a significant limitation of the capsule method – its incapacity to conduct biopsies of detected lesions.

“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,” said Andrew Meltzer, a professor of Emergency Medicine at the GW School of Medicine & Health Sciences. “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.”

Related Links:
George Washington University
AnX Robotica