P180 Magnetically-controlled capsule endoscopy to examine the upper gastrointestinal tract

Abstract

<h3>Introduction</h3> Oesophagogastroduodenoscopy (OGD) is performed in 1% of the population, is uncomfortable and carries small risks of intubation and sedation and identifies malignancy in less than 1% of cases. Capsule endoscopy is more acceptable to patients [Tai et al., Lancet Gastroenterol Hepatol 2019] and MAgnetically-controlled Capsule Endoscopy (MACE) has a 90% sensitivity in detection of gastric focal lesions, irrespective of size or site. [Liao et al., Clin Gastroenterol Hepatol 2016] <h3>Methods</h3> This is the first demonstration of MACE outside China. The procedure was performed on a healthy volunteer using the NaviCam® (Ankon Technologies Ltd., Wuhan, China), a magnetic capsule endoscope. Two joysticks control an external magnet suspended above the subject, one to move the capsule in a horizontal and vertical plane and the other to rotate the capsule on its short (to look into the lumen from the anterior or posterior wall) and long axes (a swivelling or ‘scanning’ action) by altering polarity. After an overnight fast, the subject drank 200ml water containing 80mg simethicone. After 15 mins, he drank another 1L water to further clean and distend the stomach. <h3>Results</h3> The NaviCam® was swallowed with a sip of water in the left lateral decubitus position and the magnet was suspended just above the left shoulder to capture the capsule in the oesophagus. Raising the magnet to reduce magnetic attraction allowed peristalsis to propel the capsule into the fundus. The capsule head was rotated to scan fundus and cardia, closer views of which were obtained by asking the patient to adopt the supine position. Moving the magnet towards the xiphisternum dragged the capsule down the gastric body allowing inspection of posterior (magnet lowered) and anterior (magnet raised) walls. Incisura and antrum were inspected by moving the magnet towards the left hip and antrum and pylorus further imaged with the patient in the right lateral decubitus position. Finally, the different perspective of the proximal stomach obtained with capsule endoscopy compared to fibreoptic OGD was demonstrated by asking the subject to swallow Skittles® (coloured confectionary) with the capsule positioned on the greater curve in the distal gastric body, showing the location of the cardia and a long view towards the fundus. <h3>Conclusions</h3> A normal oesophagogastric examination was demonstrated using MACE and a NaviCam®. The subject was comfortable throughout the procedure. A training programme for this new technology is being developed. Video link: https://vimeo.com/678623421/963c4549be