Detachable string magnetically controlled capsule endoscopy for complete viewing of the esophagus and stomach

Abstract

Esophageal capsule endoscopy is reported to be insufficiently accurate to replace esophagogastroduodenoscopy (EGD) because the passage of the capsule through the esophagus is passive and precludes a thorough investigation. We developed a modified capsule endoscopy technique, called detachable string magnetically controlled capsule endoscopy (DS-MCE), and performed a pilot study to assess the feasibility and safety of this novel technique. 4 healthy volunteers and 21 patients with suspected esophageal disease first underwent DS-MCE followed by EGD within 1 week. Outcomes included technical success of DS-MCE, adverse events, discomfort, and diagnostic accuracy. DS-MCE was successfully carried out in all 25 participants. No adverse events were observed. Mean overall discomfort score during DS-MCE was 0.96 (range 0 - 3). DS-MCE diagnoses were in accordance with EGD in all 25 participants. The per-patient sensitivity of DS-MCE for esophageal disease detection was 100 %. The accuracy of DS-MCE for grading esophageal varices and reflux esophagitis were 66.7 % and 100 %, respectively. DS-MCE was a feasible, safe, and well-tolerated method for viewing the esophagus and proceeding with gastric examination after string detachment.