Researchers at George Washington University have created a swallowable capsule containing a video camera that can assist in identifying lesions in the stomach. However, unlike similar devices that have been developed previously, this capsule can drive around the stomach under the control of a clinician. This allows it to thoroughly navigate and screen the entire area to identify any health issues in the stomach mucosa, such as ulcers or bleeding. The technology requires an external magnet to be placed near the stomach, and the clinician can use a joystick, just like with a video game, to control the movement of the capsule. The researchers hope that the technique will provide a replacement for more invasive approaches, such as conventional endoscopies.
Millions of traditional endoscopies are performed in the US every year. The technique is useful in assessing and diagnosing a wide variety of health issues, from gastrointestinal ulcers and bleeding to cancer. However, the procedure is mildly invasive, and not suitable for every patient – patients can require anesthesia and may need to take time from work to recover. Moreover, it is not typically possible to perform an endoscopy in a community clinic or in the ER, meaning that patients with severe stomach pain cannot receive a diagnosis without booking a second appointment for an endoscopy elsewhere in the hospital.
“I would have patients who came to the ER with concerns for a bleeding ulcer and, even if they were clinically stable, I would have no way to evaluate them without admitting them to the hospital for an endoscopy. We could not do an endoscopy in the ER and many patients faced unacceptable barriers to getting an outpatient endoscopy, a crucial diagnostic tool to preventing life-threatening hemorrhage,” said Andrew Meltzer, a researcher involved in the development of the new device. “To help address this problem, I started looking for less invasive ways to visualize the upper gastrointestinal tract for patients with suspected internal bleeding.”
The solution lies in a swallowable capsule that can record video feed of the stomach lining. However, what makes this video capsule special is its ability to navigate its way through the stomach. To date, various iterations of swallowable cameras have been developed, but typically there is no way to control their movements, meaning that gravity and the movements of the gut are the only forces acting on the device, resulting in random movements. This is not ideal, as it means that the camera could miss large sections of the stomach, and fail to spot a problem.
This new device can be controlled directly by a clinician using joysticks, similar to those used in video games. An external magnet lies close to the patient’s stomach during the procedure, creating a magnetic field that causes the capsule to move. In the future, the researchers intended to develop an AI-powered capsule navigation system, to allow for this screening to occur automatically.
“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 Meltzer. “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.”
See a video about the technology below.
Study in journal iGIE: Magnetically controlled capsule for assessment of the gastric mucosa in symptomatic patients: a prospective, single-arm, single-center, comparative study