Development and Application of Magnetically Controlled Capsule Endoscopy in Detecting Gastric Lesions

In the past 20 years, several magnetically controlled capsule endoscopes (MCCE) have been developed for the evaluation of gastric lesions, including NaviCam (ANKON), MiroCam-Navi (Intromedic), Endocapsule MGCE (Olympus and Siemens), SMCE (JIFU), and FAMCE (Jinshan). Although limited to observing esophageal and duodenal lesions and lacking the ability of biopsy, MCCE has the advantages of comfort, safety, no anesthesia, no risk of cross-infection, and high acceptability. Several high-quality RCTs showed that the diagnostic accuracy of MCCE is comparable to the traditional gastroscopy. Due to the nonnecessity of anesthesia, MCCE may be more suitable for the elderly with obvious comorbidities as well as children. With more evidences accumulated and more innovative technologies developed, MCCE is expected to be an important tool for screening of early gastric cancer or the diagnosis of gastric diseases.

Innovative Differential Magnetic Localization Method for Capsule Endoscopy to Prevent Interference Caused by the Geomagnetic Field

Wireless capsule endoscopy is an established medical application for the examination of the gastrointestinal tract. However, the robust and precise localization of these capsules is still in need of further scientific investigation. This paper presents an innovative differential magnetic localization method for capsule endoscopy to prevent interference caused by the geomagnetic field. The effect of changing the orientation of the capsule on the localization process was also examined. Simulations using COMSOL Multiphysics with the superimposed geomagnetic field were performed. The Levenberg–Marquardt algorithm was applied in MATLAB to estimate the position and orientation of the capsule. Comparing the proposed differential method with the absolute magnetic localization method under ideal conditions, the mean position and orientation errors were reduced by three orders in magnitude to less than 0.1 mm and 0.1∘ respectively. Even if sensor non-idealities are considered, the simulation-based results reveal that our proposed method is competitive with state-of-the-art geomagnetic compensation methods for static magnetic localization of capsule endoscopes. The achieved localization accuracy by applying the differential method is not dependent on the rotation of the localization system relative to the geomagnetic flux density under the made assumptions and the impact of the magnet orientation is neglectable. It is concluded that the proposed method is capable of preventing all interference whose components are approximately equal at all sensors with identical orientation.

Robotics in Gastrointestinal Endoscopy

Recent advances in endoscopic technology allow clinicians to not only detect digestive diseases early, but also provide appropriate treatment. The development of various therapeutic endoscopic technologies has changed the paradigm in the treatment of gastrointestinal diseases, contributing greatly to improving the quality of life of patients. The application of robotics for gastrointestinal endoscopy improves the maneuverability and therapeutic ability of gastrointestinal endoscopists, but there are still technical limitations. With the development of minimally invasive endoscopic treatment, clinicians need more sophisticated and precise endoscopic instruments. Novel robotic systems are being developed for application in various clinical fields, to ultimately develop into minimally invasive robotic surgery to lower the risk to patients. Robots for endoscopic submucosal dissection, autonomous locomotive robotic colonoscopes, and robotic capsule endoscopes are currently being developed. In this review, the most recently developed innovative endoscopic robots were evaluated according to their operating mechanisms and purpose of use. Robotic endoscopy is an innovative treatment platform for future digestive endoscopy.

Safety, efficacy, and maneuverability of a self-propelled capsule endoscope for observation of the human gastrointestinal tract

Background and study aims We developed a self-propelled capsule endoscope that can be controlled from outside the body with real-time observation. To improve the device, we conducted a clinical trial of total gastrointestinal capsule endoscopy in healthy subjects to ascertain whether our first-generation, self-propelled capsule endoscope was safe and effective for observing the entire human gastrointestinal tract. Patients and methods After adequate gastrointestinal pretreatment, five healthy subjects were instructed to swallow a self-propelling capsule endoscope and the safety of a complete gastrointestinal capsule endoscopy with this device was assessed. We also investigated basic problems associated with complete gastrointestinal capsule endoscopy. Results No adverse effects of the magnetic field were identified in any of the subjects. No mucosal damage was noted in any of the subjects with the use of our first-generation, self-propelling capsule endoscope. We found that it took longer than expected to observe the stomach; the view was compromised by the swallowed saliva. The pylorus was extremely difficult to navigate, and the endoscope’s fin sometimes got caught in the folds of the small intestine and colon. Conclusions To resolve the problems associated with the existing self-propelling capsule endoscope, it may be necessary to not only improve the capsule endoscopes, but also to control the environment within the gastrointestinal tract with medications and other means. Our results could guide other researchers in developing capsule endoscopes controllable from outside the body, thus allowing real-time observation.

Modular Capsules with Assembly and Separation Mechanism: Proof of Concept

As wireless capsule endoscope (WCE) technology has advanced, various studies were published on WCEs with functional modules for the diagnosis and treatment of problems in the digestive system. However, when additional functional modules are added the physical size of the WCEs will increase, making them more difficult for patients to comfortably swallow. Moreover, there are limitations when it comes to adding multi-functional modules to the WCEs due to the size of the digestive tract itself. This article introduces a controllable modular capsule endoscope driven by an electromagnetic actuation (EMA) system. The modular capsules are divided into a driving capsule and a functional capsule. Capsules with different functions are swallowed in sequence and then recombination, transportation and separation functions are carried out under the control of the EMA system while in the stomach, this approach solves the size limitation issues faced by multi-functional capsule endoscopes. The recombination and separation functions make use of a characteristic of soft magnetic materials so that their magnetization direction can be changed easily. These functions are made possible by the addition of a soft magnet to the capsule together with the precise control of magnetic fields provided by the EMA system.

Small intestine duplication cyst with recurrent hematochezia: a case report and literature review

Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.