A study from researchers in Germany showed that magnetic maneuvering of a modified capsule endoscope in the stomach of healthy volunteers under clinical conditions is safe, well-tolerated, and technically feasible. Maneuverability of the capsule within the stomach was excellent and visualization of the gastric mucosa, the inner lining of the stomach, was satisfactory in the majority of subjects.
The study participants swallowed the MMC and sherbet powder to distend the stomach, which flattens the folds of the stomach. The external magnetic paddle was used to manipulate the MMC within the stomach. MMC responsiveness was evaluated on a screen showing the MMC film in real time. The main outcome measurements were safety and tolerability, time the MMC remained in the stomach, its responsiveness to the magnetic paddle, and the area of the stomach lining visualized.
The MMC was always clearly attracted by the magnetic paddle and responded to its movements. In seven participants, maneuverability was graded as excellent because the MMC followed the rotating and tilting movements of the magnetic paddle smoothly. It remained in the stomach for approximately 39 minutes (plus or minus 24 minutes). In seven subjects, both the cardia (part of the stomach immediately adjacent to the esophagus) and the pylorus (part of the stomach through which contents are emptied into the small intestine) were inspected and 75 percent or more of the gastric mucosa was visualized (greater than or equal to 50 percent in all of the remaining subjects). The researchers noted that a learning curve was clearly recognizable (identification of MMC localization, intended movements). Some limitations of the study included small amounts of fluid that blocked the view of an area of the stomach called the fundus and gastric distention was not sufficient to flatten all gastric folds. There were no adverse events.
Study participants completed a questionnaire after the procedure, asking about difficulties swallowing, pain or other complaints. Nine participants reported no complaints and one reported mild complaints of feeling pressure. The researchers concluded that remote control of the MMC in the stomach of healthy volunteers using a handheld magnet is safe and feasible. Responsiveness of the MMC was excellent, and visualization of the stomach lining was good, although not complete, in the majority of subjects. The system appeared to be clinically valuable and should be developed further.
Source: American Society for Gastrointestinal Endoscopy