Post written by Hongxiang Gu, MD, from the Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Colon capsule endoscopy has become an alternative method to evaluate the colonic mucosa without pain, sedation, and gas insufflation in recent years. The magnetic-controlled capsule endoscopy (MCCE) system is a capsule endoscopy robot system. We performed a pilot study to assess its maneuverability and safety to examine the human colon under real-time monitoring by colonoscopy in 57 volunteers. We would like MCCE be a convenient method for colorectal tumor screening.

Figure 1. The controllable colon capsule.

Five volunteers (8.78%) were excluded because of poor bowel preparation or failure to reach the cecum before the battery was exhausted. Maneuverability of the MCCE to match the guidance of the magnetic manipulator was graded as good in 49 subjects (94.23%). In this study, only 78.84% of the capsules reached the rectosigmoid colon under the control of the external magnetic manipulator, mainly because of the limited time for the real-time monitoring procedure and the complicated anatomy of the rectosigmoid colon. We found that it was difficult for the capsule to pass the hepatic flexure of the colon positively, and changing the posture of volunteers helped to reduce the time to pass the hepatic flexure. We assumed that the maneuverability result would be poorer without real-time monitoring by colonoscopy because of the lack of insufflation. This is the first study to show the feasibility of an MCCE under real-time monitoring by colonoscopy. Although only 6 significant lesions were found using both methods, the MCCE provided good-quality images of the entire colonic mucosa and could capture the images successfully from the tip part of the colonoscopy. In summary, the colonic mucosa could be visualized positively using a controllable capsule endoscopy robot system under real-time monitoring by colonoscopy. Furthermore, its clinical application without monitoring by colonoscopy deserves further exploration.

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