Joystick-controlled video capsule promises to replace traditional endoscopy

Video capsule endoscopes are less invasive and a more attractive alternative to traditional endoscopy solutions, but to use them a doctor is first required to learn how joysticks work.
Rupendra Brahambhatt
The magnetically-controlled video capsule.
The magnetically-controlled video capsule.

AnX Robotica

Every year about seven million patients undergo endoscopy in the US. A team of researchers from George Washington University (GWU) has developed a magnetically-controlled ingestible video capsule that promises to change the way endoscopies are performed.

Ingestible video capsules already exist, but all of them come with one significant limitation —- once they enter the stomach, doctors have no control over their movement. Gravity and the natural flow of muscles in the gut decide their motion inside the body. 

On the other side, traditional tube-based endoscopy procedures are highly invasive, costly, and time-taking as they require anesthesia. Moreover, patients with severe stomach pain or cancer must make multiple appointments for their complete endoscopy.

The GWU team has introduced a technique allowing patients to take a capsule and receive a diagnosis immediately.  Moreover, the doctors can easily control the movement of the proposed video capsule using a joystick. 

“Magnetically controlled capsules could be used as a quick and easy way to screen for health problems in the upper GI (gastrointestinal) tract such as ulcers or stomach cancer,” said Andrew Meltzer, one of the researchers and a professor of emergency medicine at GW School of Medicine.

How does the new endoscopy capsule work?

Endoscopy is a medical procedure in which a doctor uses a camera-equipped device (a tube or a capsule) to look at the upper part of the digestive tract in humans. It allows doctors to detect anomalies in the body that lead to acute stomach pain, ulcers, gastric cancer, internal bleeding, and various other diseases. 

During their study, the GWU researchers wanted to develop a less invasive, hassle-free, and easily controllable endoscopy method. Their primary aim was to combine the capabilities of a tube-based endoscopy and the ease of a video capsule.

They created an ingestible capsule with a camera system and external magnets to achieve this extraordinary feat. Hand-held joysticks could easily control the movement of the magnets. So instead of relying on gravity and gut flow, the capsule now moved as per the will of the doctor who controlled the joystick. 

The researchers performed an interesting experiment to test their magnetically-controlled video capsules against the traditional endoscopy method. They used both techniques to examine 40 patients with stomach-related health problems.

“The doctor could direct the capsule to all major parts of the stomach with a 95 percent rate of visualization,” without causing any pain. Moreover, “No high-risk lesions were missed with the new method, and 80 percent of the patients preferred the capsule method to the traditional endoscopy,” the researchers note

This is the first study to demonstrate magnetically-controlled endoscopy in the US.

Limitations of magnet-driven endoscopy

Meltzer reveals that his team often encounters patients with severe ulcers or bleeding problems. Traditional endoscopy is not viable for many such patients because it might escalate their condition.

The proposed ingestible capsule doesn’t have any such risks associated with them. It’s possibly the least invasive endoscopy technique. However, it does have some limitations. For instance, currently, the video capsule can’t perform a biopsy of the identified lesions in the stomach.

Additionally, before giving the capsules to patients for endoscopy, doctors must first become proficient with the joystick controls to guarantee complete safety. Training thousands of physicians already accustomed to traditional endoscopic techniques will be challenging. 

The researchers believe that an AI-based program could allow the capsules to move autonomously. However, the AI might also make the capsules very expensive, and the doctors will still require some training to supervise the operations. 

Meltzer suggests this is a first step towards a better and faster endoscopy procedure—the need to conduct more trials involving many patients to discover more pros and cons of the capsules. 

AnX Robotica, a Texas-based AI company, owns the capsule design. Hopefully, this innovation will play a crucial role in making endoscopy more accessible, feasible, and safer for patients across the globe.

The study is published in the journal iGIE.    

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