Gastroscopy (OGD) is invasive and not always well tolerated. Capsule endoscopy of the upper GI tract might be possible if effective control allowed movement to all areas of the stomach which, unlike the small bowel, is capacious and irregular in shape. The NaviCam® (Ankon Technologies Co, Ltd Wuhan, Shanghai, China) contains magnetic material and can be controlled by an external robot magnet, the polarity and proximity of which can be manipulated using joysticks. Two frames per second allow real-time visualisation. A Chinese multicentre study has shown a high sensitivity and specificity for detecting focal gastric lesions when compared to OGD (1). In this study, imaging quality and patient tolerance of upper GI examination using the robot magnet-controlled NaviCam® was assessed.Method
Patients with symptoms of dyspepsia swallowed 100mls of water containing 10mls simethicone 15 min prior to 1L of water followed by the NaviCam®. Both clarity of gastric views and adequacy of gastric distension were assessed (1, poor; 2, reasonable; 3, good), as was completeness of views of all areas of the gastric mucosa (1,>75% obscured; 2,>50% obscured; 3,<50% obscured; 4,<25% obscured; 5, 100% visualised). Patient tolerance scores were also collected.Results
The mean age of the eight participants was 47.1±20.4 (75% male). The NaviCam® could be held stationary in the presence of peristaltic waves and could be moved proximally using a preset magnetic programme activated by a ‘shoot’ button on the joystick which caused the capsule to cartwheel proximally over the rugal folds to a chosen proximal location. Mean duration of examination was 25±7 mins. Mean clarity and distension scores of 2.5±0.5 and 2.9±0.3 were achieved. Completeness of view was 5±0 for the gastric cardia, fundus, greater and lesser curvature, anterior and posterior wall, antrum and pylorus. Few oesophageal images were obtained and duodenal images were not assessed during the live examination (but are provided following passage of the capsule through the pylorus). Three examinations were normal. Gastritis and cystic fundic gland polyps were ?diagnosed in 2 and 3 cases respectively. Anxiety, discomfort and pain scores (worst-best=0–10) were 1±0, 1.3±0.6, and 1±0 respectively.Conclusion
The NaviCam® demonstrates excellent control and gastric views and is extremely well tolerated. Greater frame acquisition rate is likely to improve oesophageal visualisation.Disclosure of Interest
H.-L. Ching Conflict with: Ankon, Conflict with: Travel expenses to capsule conference from Ankon., M Hale: None Declared, R Sidhu: None Declared, M McAlindon Conflict with: Ankon, Conflict with: Travel expenses to capsule conference from Ankon.