ADTH-08 Robot magnet-controlled upper gastrointestinal capsule endoscopy: non-invasive investigation with excellent patient tolerance

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Abstract

Introduction

Gastroscopy (OGD) is invasive and not always well tolerated. The NaviCam® (Ankon Technologies Co. Ltd., Shanghai, China) combines capsule endoscopy technology with external robot magnetic control. Operator joysticks command the robot to steer the capsule within the stomach. Real-time visualisation is displayed on two workstation monitors. When compared to OGD, the NaviCam® has already demonstrated high sensitivity and specificity for identifying focal gastric lesions.1 The focus of this study was to grade imaging quality and patient tolerance of the NaviCam®.

Method

Patients with dyspepsia were recruited. Patients swallowed 100 mls of water (containing 10 mls simethicone) 15 min prior to 1L of water followed by the NaviCam®. Clarity of views and adequacy of gastric distension were assessed (1, poor; 2, reasonable; 3, good), as was completeness of views of the oesophagogastric mucosa (1,>75% obscured; 2,>50% obscured; 3,<50% obscured; 4,<25% obscured; 5, 100% visualised). Patient tolerance scores were collected (worst-best=0–10). All patients subsequently had OGD and tolerance scores were compared to those of the NaviCam®.

Results

Eighteen participants were included (mean age 53±16.1 years, 27.8% male). The NaviCam could be held stationary within the stomach (resisting peristaltic waves) and could cartwheel over rugal folds to a chosen proximal location using a preset programme activated by a ‘shoot’ button on the joystick. Mean examination duration was 25±3.4 mins. Mean clarity (2.3±0.7) and distension scores (2.9±0.3) were good. Complete views (5±0) for all areas of the gastric body (greater and lesser curvature, anterior and posterior wall) and distal stomach (antrum and pylorus) were achieved. Views of the oesophagus (4.3±1.3) and proximal stomach (cardia, 4.9±0.2; fundus 4.8±0.3) were also good. Duodenal images were not assessed real-time (but are provided after the capsule traverses the pylorus). Tolerance scores for anxiety, discomfort and pain were all lower with MACE compared to OGD (2.2±1.4 vs 5.8±3, 1.3±1 vs 4.9±3, 2.4±2.4 vs 3.4±2.5, respectively; p<0.05 for all). Tolerance scores for undesirable symptoms associated with upper gastrointestinal (GI) endoscopy, namely gagging, choking and bloating were also more favourable with MACE compared to OGD (1.4±1.6 vs 5.4±3.3, 1.3±1.2 vs 4.8±3.3, 1.2±0.5 vs 2.9±2.0, respectively; p<0.05 for all).

Conclusion

The NaviCam® demonstrates excellent oesophagogastric views. The NaviCam® is extremely well tolerated compared to OGD and patients experience significantly fewer undesirable symptoms associated with upper GI endoscopy.

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