Search

Purpose: To investigate the interaction of a robot assisted magnetically driven wireless capsule endoscope (WCE) with colonic tissue, as it traverses the colorectal bends in the dorsal and ventral directions, relying only on the feedback from a 3D accelerometer. We also investigate the impact of shell geometry and water insufflation on WCE locomotion. Methods: A 3D printed incline phantom, lined with porcine colon, was used as the experimental platform, for controlled and repeatable results. The tilt angle of WCE was controlled to observe its influence on WCE locomotion. The phantom was placed underwater to observe the effects of water insufflation. The experiments were repeated using the two capsule shell geometries to observe the effect of shell geometry on WCE locomotion. Results: Friction between WCE and intestinal tissue increased when the tilt angle of the WCE was lower than the angle of the incline of the phantom. Increasing the WCE tilt angle to match the angle of the incline reduced this friction. Water insufflation and elliptical capsule shell geometry reduced the friction further. Conclusion: Tilting of the WCE equal to, or more than the angle of the incline improved the WCE locomotion. WCE locomotion was also improved by using elliptical capsule shell geometry and water insufflation. Abbreviations: CRC: colorectal cancer; GI: gastrointestinal; MRI: magnetic resonance imaging; WCE: wireless capsule endoscope Robot-assisted magnetic capsule endoscopy; navigating colorectal inclinations

Background Previous studies have shown that the Kyoto classification of gastritis can accurately predict H. pylori infection status on conventional gastroscopy. The aim of this study was to test whether the Kyoto classification of gastritis applies well to magnetic controlled capsule endoscopy (MCCE). Methods We consecutively recruited 227 participants who underwent both MCCE and urea breath tests (UBTs). Two physicians who were blinded to the UBT results independently made the diagnosis of H. pylori infection status according to 10 findings listed in the Kyoto classification of gastritis after reviewing MCCE images. We also developed 2 predictive models to assess H. pylori infection status by combining these 10 findings. Results The MCCE’s overall diagnostic accuracy for H. pylori infection status was 80.2%. The sensitivity, specificity and diagnostic odds ratio (DOR) for current infection were 89.4%, 90.1% and 77.1, respectively. Major specific findings were mucosal swelling and spotty redness for current infection, regular arrangement of collecting venules (RAC), streak redness, fundic gland polyp (FGP) for noninfection, and map-like redness for past-infection. In the two prediction models, the area under the curve (AUC) values for predicting noninfection and current infection were 84.7 and 84.9, respectively. Conclusions The Kyoto classification of gastritis applied well to MCCE. H. pylori infection status could be accurately assessed on MCCE according to the Kyoto classification of gastritis.

Background Patients with Crohn’s disease (CD) undergo frequent endoscopic procedures, with visualization of the gastrointestinal mucosa central to treatment decision-making. Subsequently, a noninvasive alternative to optical colonoscopy (OC) would be welcomed. One such technology is capsule endoscopy, including the PillCam COLON 2 (PCC2), though research validating its use in ileocolonic CD is limited. This study aims to compare PCC2 with ileocolonoscopy (OC) in assessing mucosal CD through use of a standardized scoring system. Methods At an Australian tertiary hospital, same-day PCC2 and ileocolonoscopy results of 47 CD patients, with known nonstricturing disease, were prospectively collected and analyzed for correlation and agreement. Deidentified recordings were reported by a single expert gastroenterologist. Mucosal disease was quantified using the Simple Endoscopic Score for Crohn’s Disease (SES-CD). The SES-CD results of paired endoscopic modalities were compared in total per bowel segment and per SES-CD variable. Results Of 47 PCC2 recordings, 68% were complete, fully assessing terminal ileum to rectum, and OC was complete in 89%. Correlation (r) between total SES-CD scores was strongest in the terminal ileum (r = 0.77, P < .001), with the SES-CD variable of “ulcer detection” showing the strongest agreement. The PCC2 (vs OC) identified additional ulcers in the terminal ileum; ascending, transverse, and descending colon; and rectum; scores were 5 (1), 5 (3), 1 (1), 2 (1), and 2 (2), respectively. Conclusions The PCC2 shows promise in assessing ileocolonic mucosa, especially in proximal bowel segments, with greater reach of visualization in the small bowel. Given the resource and safety considerations raised by the Coronavirus disease 2019 pandemic, capsule endoscopy has particular significance. This article aims to contribute to the limited body of research surrounding the validity of capsule endoscopy technology in assessing ileocolonic mucosa in Crohn’s Disease patients. In doing so, an alternative option for patients enduring frequent endoscopies is given potential.

BACKGROUND AND AIM We retrospectively determined the safety and efficacy of the endoscopic delivery (ED) of capsule endoscopes. METHODS We enrolled 10,156 patients who underwent small bowel capsule endoscopy (SBCE), 3182 who underwent patency capsule (PC), and 1367 who underwent colon capsule endoscopy (CCE), at 11 gastroenterological and nine pediatric centers. RESULTS Small bowel capsule endoscopies, PCs, and CCEs were endoscopically delivered to 546 (5.4%), 214 (6.7%), and 14 (1.0%) patients, respectively. Only mild complications occurred for 21.6% (167/774), including uneventful mucosal damage, bleeding, and abdominal pain. Successful ED of SBCE to the duodenum or jejunum occurred in 91.8% and 90.7% of patients aged

The wearable localization system for wireless capsule endoscopy (WCE) is a potential technology to realize rapid diagnosis and treatment of the gastrointestinal (GI). However, the electromagnetic localization accuracy of WCE still needs to be improved. In this paper, based on RSSI electromagnetic fading model, the accurate fitting parameter values are obtained by Kalman filter and the least square method. A novel weighted centroid localization (WCL) algorithm based on exponential weights is proposed, which can achieve high-accuracy localization by using only sparse reception matrix. The simulation results show that when the standard deviation of the localization data is 7.85, the localization root mean square error (RMSE) is 25.4 mm; when the standard deviation of the localization data is 5.475, the localization RMSE is 2.5 mm. These two localization RMSEs are 38% and 79% less than those of the conventional centroid localization algorithm, respectively. An experimental platform of wearable wireless communication and localization system using 24 array receiving antennas is developed in human phantom environment. The experimental results show that the wearable WCE electromagnetic localization system based on the proposed algorithm achieves a localization RMSE of 36.3 mm, which is 17% lower than that of the conventional centroid localization algorithm and meets the needs of clinical diagnosis.

Advanced computer vision technologies can be used to improve the performance of capsule endoscopy. Specifically, new technologies can be used to enhance the image quality of capsule endoscopes, which has previously been limited by mechanical constraints. The trajectory of a capsule endoscope, which can be estimated by reconstructing the captured images, helps to predict the location of lesions. Computer vision technology is utilized in a more practical way in a recently developed capsule endoscope comprising a stereo camera. Using this device, images can be interpreted in three dimensions, enabling more accurate measurements of size. The use of deep learning for image recognition is associated with an improved lesion detection rate and reduced reading time in clinicians. This evolving technology requires close cooperation between medical and IT professionals for optimized clinical use. (Korean J Med 2021;96:190-194)

Magnetic navigation capsule endoscopy (MNCE) is considered to be an important means to realize the controllable and precise examination of capsule endoscopy (CE) in the unstructured gastrointestinal (GI) tract. For the current magnetic navigation system (MNS), due to the limitation of workspace, driving force, and control method of the CE, only clinical application in the stomach has been realized, whereas the examination of other parts of the GI tract is still in the experimental stage. More preclinical studies are needed to achieve the multisite examination of the GI tract.Based on the MNS (Supiee) developed in the laboratory, an X-ray imaging system with magnetic shielding and a commercial CE are integrated to form the MNCE system. Then, in vivo GI tract experiments with a porcine model are performed to verify the clinical feasibility and safety of this system. Moreover, the effects of different control modes on the efficiency and effect of GI tract examination are studied.Animal experiments demonstrate that with the MNCE system, it is convenient to achieve steering control in any direction and multiple reciprocating movements of CE in the GI tract. Benefiting from the flexibility of the three basic control modes, the achieved swing movement pattern of CE can effectively reduce the inspection time. It is demonstrated that the esophageal examination time can be reduced from 13.2 to 9.2 min with a maximum movement speed of 5 mm/s.In this paper, the feasibility, safety, and efficacy of the MNCE system for a one-stop examination of the in vivo GI tract (esophagus, stomach, and colorectum) is first demonstrated. In addition, complex movement patterns of CE such as the swinging are proved to effectively improve examination efficiency and disease detection rates. This study is crucial for the clinical application of the MNCE system.

This paper studies the use of electromagnetic induction in localization of wireless capsule endoscopes (WECs). There is still currently a need for an accurate localization system to enable localizing possible findings in the gastrointestinal tract, and to develop an active steering system for the capsule. Developing an optimal localization system requires the sensitivity of the system to be analyzed. In this paper, three different coil geometries are modelled with a computer simulation platform, and their sensitivities and target responses are compared. In order to do that, a formulation for the sensitivity based on the dipole model approximation is presented. The first coil array is based on literature and is used as a reference. The second array presents how having more transmit-receive channels in the array effects the sensitivity. The third coil array simulates the effect of increasing the field excitation intensity in different directions by using a three-axial Helmholtz array. In addition, both proposed coil arrays utilize larger coils than the reference. As a result, it seems that both increasing the coil size and the number of field projections interrogating the target increase the overall sensitivity in the region of interest and the target response. The findings suggest that an optimal coil array could utilize both large coils and multiple transmit-receive channels to increase the number of independent fields incident onto the target.

Localizing the endoscopy capsule inside gastrointestinal (GI) system provides key information which leads to GI abnormality tracking and precision medical delivery. In this paper, we have proposed a new method to localize the capsule inside human GI track. We propose to equip the capsule with four side wall cameras and an Inertial Measurement Unit (IMU), that consists of 9 Degree-Of-Freedom (DOF) including a gyroscope, an accelerometer and a magnetometer to monitor the capsule’s orientation and direction of travel. The low resolution mono-chromatic cameras, installed along the wide wall, are responsible to measure the actual capsule movement, not the involuntary motion of the small intestine. Finally, a fusion algorithm is used to combine all data to derive the traveled path and plot the trajectory. Compared to other methods, the presented system is resistive to surrounding conditions, such as GI nonhomogeneous structure and involuntary small bowel movements. In addition, it does not require external antenna or arrays. Therefore, GI tracking can be achieved without disturbing patients’ daily activities.

The cause of small intestinal bleeding (SIB) may be elusive despite exhaustive testing. This article describes the current understanding of SIB regarding evaluation, with emphasis on the use of video capsule endoscopy (VCE) as a diagnostic procedure. This article addresses the utility of provocative testing in challenging cases and the performance of endoscopic procedures on active antithrombotic therapy. Specific recommendations accompany this article, including use of antithrombotic agents to stimulate bleeding when clearly indicated; performance of endoscopic procedures on active antithrombotic therapy; and progressive adoption of VCE and device-assisted enteroscopy in the inpatient setting.

ObjectiveIntestinal flora and metabolites are associated with multiple systemic diseases. Current approaches for acquiring information regarding microbiota/metabolites have limitations. We aimed to develop a precise magnetically controlled sampling capsule endoscope (MSCE) for the convenient, non-invasive and accurate acquisition of digestive bioinformation for disease diagnosis and evaluation.DesignThe MSCE and surgery were both used for sampling both jejunal and ileal GI content in the control and antibiotic-induced diarrhoea groups. The GI content was then used for microbiome profiling and metabolomics profiling.ResultsCompared with surgery, our data showed that the MSCE precisely acquired data regarding the intestinal flora and metabolites, which was effectively differentiated in different intestinal regions and disease models. Using MSCE, we detected a dramatic decrease in the abundance of Bacteroidetes, Patescibacteria and Actinobacteria and hippuric acid levels, as well as an increase in the abundance of Escherichia–Shigella and the 2-pyrrolidinone levels were detected in the antibiotic-induced diarrhoea model by MSCE. MSCE-mediated sampling revealed specific gut microbiota/metabolites including Enterococcus, Lachnospiraceae, acetyl-L-carnitine and succinic acid, which are related to metabolic diseases, cancers and nervous system disorders. Additionally, the MSCE exhibited good sealing characteristics with no contamination after sampling.ConclusionsWe present a newly developed MSCE that can non-invasively and accurately acquire intestinal bioinformation via direct visualization under magnetic control, which may further aid in disease prevention, diagnosis, prognosis and treatment.

Due to recent advancements in complementary metal-oxide-semiconductor (CMOS) cameras, transferring high resolution images and videos are possible in wireless capsule endoscopy. High-data-rates communication is required for such data, which is possible using multiple-input-multiple-output (MIMO) antennas. In this paper, a low-sized, compact, high-data-rate, highly isolated two-element MIMO antenna with a large bandwidth has been proposed at 2.45 GHz for wireless capsule endoscopy. The geometry of the antenna ($$5\times 4.2 \times 0.12\,\hbox {mm}^{3}$$ 5 × 4.2 × 0.12 mm 3 ) is kept small using meandered geometry, defected ground structure, and high permittivity of the substrate. A wider bandwidth of 620 MHz (2.15–2.77 GHz) is achieved by exciting dual-modes of the antenna using defected ground structure. Furthermore, a lower mutual coupling between the antennas (30.1 dB at 2.45 GHz) is realized, despite the small edge-to-edge gap of 0.5 mm, using combination of defected ground structure and I-shaped stub. Keeping in mind of system level configuration, this antenna is simulated and measured inside a capsule device by considering effects of the other components and the device itself. The practical measurements are performed by inserting the capsule device (containing the MIMO antenna) inside minced meat. To check the safety and effectiveness of the proposed MIMO antenna, it’s specific absorption rate (SAR) and link budget are calculated and validated. In addition, the $$2\times 2$$ 2 × 2 channel specifications are verified which shows satisfactory performance. This antenna has high channel capacity ($$\approx 8.2 \,\hbox {bps/Hz}$$ ≈ 8.2 bps/Hz at $$\hbox {SNR} = 20 \,\hbox {dB}$$ SNR = 20 dB ) than single-input-single-output (SISO) antennas, thus, is a suitable choice for high-data-rate capsule endoscopic devices. To the best of the authors’ knowledge, this is the first implantable MIMO antenna reported so far with such lower dimension and wider bandwidth.

Wireless capsule endoscopes take and send photos of the human digestive tract, which are used for medical diagnosis. The capsule’s location enables exact identification of the regions with lesions. This can be carried out by analyzing the parameters of the electromagnetic wave received from the capsule. Because the human body is a complex heterogeneous environment that impacts the propagation of wireless signals, determining the distance between the transmitter and the receiver based on the received power level is challenging. An enhanced approach of identifying the location of endoscope capsules using a wireless signal phase detection algorithm is presented in this paper. For each capsule position, this technique uses adaptive estimation of human body model permittivity. This approach was tested using computer simulations in Remcom XFdtd software using a numerical, heterogeneous human body model, as well as measurements with physical phantom. The type of transmitting antenna employed in the capsule also has a significant impact on the suggested localization method’s accuracy. As a result, the helical antenna, which is smaller than the dipole, was chosen as the signal’s source. For both the numerical and physical phantom studies, the proposed technique with adaptive body model enhances localization accuracy by roughly 30%.

Medical procedures often involve a device moving through a natural lumen of the human body (e.g., intestines, blood vessels). However, with existing technology, it is difficult, impossible, or traumatic to reach certain locations. In this article, we present a magnetically actuated soft-robotic concept for use in endoluminal applications (e.g., capsule endoscopes and catheters). The soft endoluminal robot is a simple device comprising two or more permanent magnets, axially magnetized and embedded co-axially with alternating polarity in a compliant body, with an optional internal lumen, actuated by an external rotating magnetic dipole field. We use simulations to elucidate the actuation concept’s underlying physics and, combined with experiments, demonstrate how the proposed concept outperforms other potential variations. We experimentally demonstrate the robustness to misalignment between the soft robot and the applied field, enabling operation in different applications without precise knowledge of the robot’s orientation or precise control of the actuator dipole field. Experiments are then performed inside a synthetic bowel to compare capsule-endoscope-size robots and multi-component robots formed by connecting multiple capsule-endoscope-size robots axially. Finally, experiments in a synthetic stomach show how the concept lends itself to directed self-assembly in the stomach, thus creating robots that are larger than could be swallowed.

Pigs are used to model humans in gastrointestinal (GI) studies because of their comparable size, physiology and behaviour: both are monogastric omnivores. A porcine surgical model for testing novel, tethered ultrasound capsule endoscopes (USCE) requires a clean, motile small intestine. Recommendations for human GI tract preparation before the mechanically similar process of video capsule endoscopy describe using oral purgatives, while high-carbohydrate drinks are recommended before colorectal surgery. Reports of the GI preparation of pigs exist but lack technical details, that is, administration, efficacy and side effects. This report details feeding a high-energy liquid diet to 11 female pigs undergoing surgery and USCE which was readily accepted and easily administered, and which produced a clean, motile small intestine and caused no detectable physiological/behavioural abnormalities.

Wireless capsule endoscope (WCE) is a new diagnostic device that can be utilised for evaluating the whole digestive tract if effectively actuated. In this research, a new one degree of freedom (1DOF) actuation system based on a magnetic levitation concept is proposed for the capsule endoscope navigation system. The proposed system is used to move a permanent magnet inserted in WCE body by an arrangement of the current controlled electromagnetic actuator placed on a 3DOF movable frame. The aim of this study is to design a proportional–integral–derivative (PID) controller to suspend the capsule and keep it at a demand test region. DC and AC magnetic field-based positioning systems using the Hall effect sensor and the coil sensor, respectively are used to provide the controller by capsule position feedback. Improvement of the position feedback accuracy based on AC magnetic field using discrete Fourier transform is presented. Realistic simulation design of the system is implemented using Matlab/Simulink environment to validate the PID controller. The navigation scheme is implemented practically utilszing digital signal processor to verify the effectiveness of the controller. Finally, simulation and experimental results of the capsule navigation system are presented to show the performance of the proposed controller.

Robotic capsule endoscopes (RCEs) are being widely investigated to improve the state of various endoscopy procedures. This article presents the novel design of a multi-DOF sensor-enabled RCE for colonoscopies (Endoculus) and evaluates porcine in vivo and ex vivo performance. The novelty of the design includes a custom “double-worm” drive that removes axial gear forces while reducing radial moments, and the full parameterization of gear geometries allows for size minimization via an optimization routine over design constraints. Two independently controlled motors drive micro-pillared treads above and below the device allowing for two-degrees of freedom (2-DOF) skid-steering, even in a collapsed lumen. The Endoculus contains all functionality of a traditional endoscope: a camera, adjustable light emitting diodes (LEDs), channels for insufflation and irrigation, and a tool port for endoscopy instruments (e.g., forceps, snares, etc.). Additionally, the Endoculus carries an inertial measurement unit, magnetometer, motor encoders, and motor current sensors to aid in future autonomy strategies. Porcine surgical evaluation demonstrated locomotion up to 40 mm/s on the colon mucosa, 2-DOF steering, the ability to traverse haustral folds, and functionality of endoscopy tools. This platform will enable future validation of feedback control, localization, and mapping algorithms in the unconventional in vivo environment.

Wireless capsule endoscopes have revolutionized diagnostic procedures in the gastrointestinal (GI) tract by minimizing discomfort and trauma. Biopsy procedures, which are often necessary for a confirmed diagnosis of an illness, have been incorporated recently into robotic capsule endoscopes to improve their diagnostic functionality beyond only imaging. However, capsule robots to date have only been able to acquire biopsy samples of superficial tissues of the GI tract, which could generate false-negative diagnostic results if the diseased tissue is under the surface of the GI tract. To improve their diagnostic accuracy for submucosal tumors/diseases, we propose a magnetically actuated soft robotic capsule robot, which takes biopsy samples in a deep tissue of a stomach using the fine-needle biopsy technique. We present the design, control, and human-machine interfacing methods for the fine-needle biopsy capsule robot. Ex vivo experiments in a porcine stomach show 85% yield for the biopsy of phantom tumors located underneath the first layers of the stomach wall.

Objectives This multicenter, cross-sectional study aimed to elucidate the efficacy and safety of the AdvanCE capsule endoscope delivery device for children in Japan. Methods The present study analyzed 183 cases of small bowel capsule endoscope (SBCE) insertion performed using the AdvanCE in 154 patients aged less than 18 years at participating institutions between 2013 and 2017. Statistical analyses were conducted to identify factors contributing to the completion rate for the entire small intestine examination, small intestine transit time, adverse events and technical issues. Results The commonest reason for using the AdvanCE was the patient's inability to swallow the SBCE, which was attributed to young age. SBCE was successfully delivered into the stomach or duodenum in 180 cases and was placed in the duodenum in 90% patients. In 89% patients, the entire small intestine was completely examined, and in 63% patients, findings leading to a new diagnosis or involving changing or maintaining the treatment strategy were obtained. No severe adverse events were observed; however, mild adverse events were observed in 35% patients. No factors considerably contributed to the completion rate for the entire small intestine examination or small intestine transit time and onset of technical issues. The factors that contributed to mild adverse events included intravenous anesthesia, technical issue, and absence of prior insertion of a patency capsule using the AdvanCE. Conclusion The AdvanCE is well tolerated and effective for children.

The invention of wireless capsule endoscopy yields the potential of diagnosis throughout the daily life of a patient. Nevertheless, doctors require the precise localization of the capsule during the entire diagnosis procedure. So far, static magnetic localization for capsule endoscopes has yielded promising results. However, it suffers significantly from interference caused by the geomagnetic flux density. In this paper, a differential magnetic localization method, which addresses this problem, is evaluated experimentally. A localization system with twelve magnetic sensors was used to localize a small cylindrical permanent magnet, which was assumed to be integrated into a capsule. The sensors were grouped into pairs, that were equally orientated. By subtracting the measured values of those sensors, the geomagnetic flux density was canceled out. The localization performance was evaluated applying static and dynamic scenarios and the obtained mean position and orientation errors did not exceed 3mm and 2.1 °, respectively. Thus, the proposed system is feasible to enable daily life activities during diagnosis and its performance significantly better than state-of-the-art geomagnetic compensation methods.

The reliable localization for capsule endoscopes is an open research topic. In this study, a low-frequency magnetic localization method for capsule endoscopes with an integrated active coil is proposed. The spatial constraint, the limited battery capacity and the ferromagnetic battery shell of commercial capsules were considered. The generated magnetic flux density was evaluated depending on the distance to the coil and the maximal detectable range was determined. Twelve sensors were arranged in rings and by comparing the measured magnetic flux density with the analytic dipole model, the position and orientation of the coil were reconstructed. The results revealed that the ferromagnetic shell increases the magnetic moment of the coil by approximately a factor of 2.4. Moreover, the mean position and orientation errors were 0.5 mm and 0.3°. Furthermore, by using only the three closest sensors to the coil, a similar localization performance was achieved. Therefore, it was concluded that it is a feasible approach to choose the sensors, which measure the strongest signal to address the problem of the maximal detectable range of magnetic sensors. Moreover, by considering the limited battery capacity, the localization with the proposed coil must be conducted in short time intervals instead of continuously.

Static magnetic localization of capsule endoscopes is an established research area but the ferromagnetic battery shell of capsule endoscopes has not been investigated so far. Therefore, in this study, the batteries were enclosed by a ring magnet, suitable for a commercial capsule, and the magnetization effect of the ferromagnetic battery shell was evaluated. The magnet and the batteries were moved along the x-axis while the position and orientation errors were determined to investigate if the dipole model applies for the setup. The achieved mean position and orientation errors were below 1 mm and 0.1°, respectively. It was concluded that the built-in batteries can advantageously increase the magnetic flux density up to 25 %, depending on the magnetization direction of a ring magnet and the dipole model applies even with the enclosed batteries.

As wireless capsule endoscope (WCE) technology has advanced, various studies were published on WCEs with functional modules for the diagnosis and treatment of problems in the digestive system. However, when additional functional modules are added the physical size of the WCEs will increase, making them more difficult for patients to comfortably swallow. Moreover, there are limitations when it comes to adding multi-functional modules to the WCEs due to the size of the digestive tract itself. This article introduces a controllable modular capsule endoscope driven by an electromagnetic actuation (EMA) system. The modular capsules are divided into a driving capsule and a functional capsule. Capsules with different functions are swallowed in sequence and then recombination, transportation and separation functions are carried out under the control of the EMA system while in the stomach, this approach solves the size limitation issues faced by multi-functional capsule endoscopes. The recombination and separation functions make use of a characteristic of soft magnetic materials so that their magnetization direction can be changed easily. These functions are made possible by the addition of a soft magnet to the capsule together with the precise control of magnetic fields provided by the EMA system.

Aim To compare feasibility and safety after gastrointestinal checkup by standing-type magnetically controlled capsule endoscopy (SMCE) and conventional gastroscopy. Methods This was a prospective multicenter, blinded study that compared SMCE with gastroscopy in patients from April 2018 to July 2018. All patients first underwent SMCE and then subsequently had gastroscopy with i.v. anesthesia. We calculated the compliance rates of gastric lesion detection by SMCE using gastroscopy as the standard. Capsule retention rate, incidence of adverse events, and patient satisfaction were documented throughout the study. Results One hundred and sixty-one patients who completed SMCE and gastroscopy were included in the analysis. Positive compliance rate among SMCE and gastroscopy was 92.0% (95% CI: 80.77%-97.78%). Negative compliance rate was 95.5% (89.80%, 98.52%). Moreover, overall compliance rate was 94.41% (89.65%, 97.41%). Sixty-four pathological outcomes were identified. Of these 64 outcomes, 50 were detected by both procedures. The gastroscopy method neglected seven findings (such as five erosions, one polyp, and one ulcer). Furthermore, SMCE also overlooked seven lesions (i.e. one erosion, two polyps, one atrophy, and three submucosal tumors). Capsule retention or related adverse events were not reported. Conclusion Standing-type magnetically controlled capsule endoscopy provides equivalent agreement with gastroscopy and may be useful for screening of gastric illnesses without any anesthesia.

Localisation of an active capsule endoscope inside the stomach has different challenges. One of them is the estimation of the capsule's roll angle. Another challenge is adjusting the distance between the capsule and the stomach to achieve high-quality imaging in the region of interest. In this study, an optimised image-guided localisation (O-Localisation) method is proposed to estimate the roll angle and the scale factor between the consecutive frames. The distance between the capsule and walls of the stomach can be adjusted using the suggested fuzzy adjuster, which is developed based on the estimated scale factors and calibration parameters. This new method is only based on visual information extracted from wireless capsule endoscope video frames. The results show that this method can accurately estimate the rotation angles and scale factors with errors

BACKGROUND: The purpose of this study was to evaluate the effect of a prophylactic laparoscopic gastropexy on gastric motility in healthy large‐breed dogs. METHODS: This was a prospective pilot study with nine healthy client‐owned dogs. Each dog was its own control. Gastric motility was evaluated before and after laparoscopic gastropexy. Dogs were fed a standard diet three weeks before and after surgery. Gastric motility was measured before and 3 weeks after surgery. A wireless motility capsule (WMC) was used to measure gastric pH, intragastric pressure, temperature, frequency of contractions, motility index (MI) and transit time. Non‐parametric statistical analysis was used to compare the paired data. Clients were contacted for follow‐up information 2 years postoperatively. RESULTS: Median frequency of gastric contractions was 1.3 (range, 0.6–1.9 contractions/min) before gastropexy and 1.0 (range, 0.3–2.6 contractions/min) after gastropexy (P = 0.820). Median MI was 49.2 (range, 23.7–96.6) before gastropexy and 28.1 (range, 12.2–148.9) after gastropexy (P = 0.652). Median gastric emptying time was 1140 (range, 486–1230 min) before gastropexy and 1110 (range, 306–2610 min) after gastropexy (P = 0.570). During the hour before the WMC passed through the pylorus, median MI was 72.2 (range, 48.2–549.3) before gastropexy and 52.9 (range, 15.20–322.8) after gastropexy (P = 0.734), and frequency of contractions was 1.1 (range, 0.9–4.1 contractions/min) before gastropexy and 1.2 (range, 0.5–3.0 contractions/min) after gastropexy (P = 0.652). CONCLUSION: Motility in the stomach did not change in healthy dogs after prophylactic laparoscopic gastropexy. We conclude that preventive laparoscopic gastropexy does not induce gastroparesis.

Using positron emission markers for the localization of a robotic capsule endoscope is promising because it does not require onboard space or built-in battery for operation. Further, its compatibility with magnetic actuation is another significant advantage compared with conventional magnetic localization methods reported in the literature. In this paper, we propose a new tracking algorithm based on rigid-body transformation and gamma rays emitted from three positron emission markers onboard to localize an endoscopic capsule operating within the gastrointestinal tract of the human body. Different from traditional rigid-body transformation based on datasets of 3-D points, our method estimates the transformation parameters (e.g., translation vector and rotation angle) from several groups of 3-D lines in order to determine the locations of the markers emitting the gamma rays. Validated by both simulation data using a voxelized phantom in the Geant4 Application for Emission Tomography toolkit and the experimental data collected from a positron emission tomography scanner, the new localization method shows a significant improvement in the tracking accuracy (an average position error of 0.4 mm and orientation error of 1.9°) and the failure rate (18/9600 localization runs), compared to the localization results reported in the literature.

We report on a remotely actuated novel anchoring system (patent-pending) based on a curved scissor-extending mechanism and the principle of a magnetic spring for wireless capsule endoscopy. An analytical model is proposed to determine the magnetic torque needed for the actuation of the anchoring mechanism inside the gastrointestinal tract. Magnetic finite element simulations are conducted to better comprehend the operation principle of the anchoring mechanism and select the magnetic spring. A prototype of the anchoring module is designed, fabricated, and attached to a commercial endoscopic capsule as an add-on accessory, without increasing its diameter. The in vitro experiments demonstrated that a capsule endoscope equipped with this low footprint anchoring module could effectively be stopped and released inside the porcine intestine by turning on and turning off the external magnetic field. The experiments showed that the proposed anchoring system raised the anchoring force by approximately five times after its activation, which provides the capsule with sufficient stopping force to overcome the peristaltic force and other propulsive forces in the gastrointestinal tract. The proposed anchoring system will provide a practical and novel solution to enhancing the capabilities of the wireless endoscopic capsules by allowing them to effectively undertake diagnostic, therapeutical, surgical, and sample collection tasks within the human gastrointestinal tract.

Newer capsule with a panoramic viewing mode is available and might increase the detection rate of bleeding lesions in patients with obscure gastrointestinal bleeding (OGIB). Furthermore, an improved patient acceptance rate is expected.In a randomized prospective comparative multicenter study, patients with OGIB were included and examined either with CapsoCam SV-1 or with PillCam SB 3. Detection of bleeding lesions, transit, and evaluation time and adverse events were evaluated. Physicians were interviewed about their experience with both capsules and the evaluation software. A detailed subject questionnaire analyzed acceptance of each capsule. Follow-up was 3 months.In total, 181 patients with OGIB were recruited into the study. After exclusion of 28 patients 153 patients were randomized and CapsoCam SV-1 (n=78) or PillCam SB 3 (n=75) was administered. CapsoCam SV-1 detected more cases of bleeding (31/79, diagnostic yield 39.7%) compared with PillCam SB 3 (26/75, diagnostic yield 34.6%, NS). Transit time of both capsules was not different. Evaluation time with PillCam SB 3 was superior to CapsoCam SV-1 (27 vs. 40 min, P=0.01). In total, 95% of the physicians were satisfied with each capsule system and evaluation software. The acceptance rate of the patients to retrieve the CapsoCam SV-1 was high. Adverse events/serious adverse events were 17.9%/1.3% with CapsoCam SV-1 and 16%/0% with PillCam SB 3. Rebleeding rate was 28.75% within 3 months.CapsoCam SV-1 detected more lesions; however, relevant bleeding sources were visualized by both capsules. Physician's satisfaction was high with both capsule systems and evaluation software. Patient's acceptance with CapsoCam SV-1 was unexpectedly high. Serious adverse events were 0% with PillCam SB 3 and 1.3% with CapsoCam SV-1.

Capsule endoscopy (CE) is a preferred diagnostic method for analyzing small bowel diseases. However, capsule endoscopes capture a sparse number of images because of their mechanical limitations. Post-procedural management using computational methods can enhance image quality. Additional information, including depth, can be obtained by using recently developed computer vision techniques. It is possible to measure the size of lesions and track the trajectory of capsule endoscopes using the computer vision technology, without requiring additional equipment. Moreover, the computational analysis of CE images can help detect lesions more accurately within a shorter time. Newly introduced deep leaning-based methods have shown more remarkable results over traditional computerized approaches. A large-scale standard dataset should be prepared to develop an optimal algorithms for improving the diagnostic yield of CE. The close collaboration between information technology and medical professionals is needed.

Due to the constantly growing geriatric population and the projected increase of the prevalence of chronic diseases that are refractory to drugs, implantable medical devices (IMDs) such as neurostimulators, endoscopic capsules, artificial retinal prostheses, and brain-machine interfaces are being developed. According to many business forecast firms, the IMD market is expected to grow and they are subject to much research aiming to overcome the numerous challenges of their development. One of these challenges consists of designing a wireless power and data transmission system that has high power efficiency, high data rates, low power consumption, and high robustness against noise. This is in addition to minimal design and implementation complexity. This manuscript concerns a comprehensive survey of the latest techniques used to power up and communicate between an external base station and an IMD. Patient safety considerations related to biological, physical, electromagnetic, and electromagnetic interference concerns for wireless IMDs are also explored. The simultaneous powering and data communication techniques using a single inductive link for both power transfer and bidirectional data communication, including the various data modulation/demodulation techniques, are also reviewed. This review will hopefully contribute to the persistent efforts to implement compact reliable IMDs while lowering their cost and upsurging their benefits.