RESUMEN
BACKGROUND AND STUDY AIMS: Capsule endoscopy is an attractive alternative to colorectal cancer screening by conventional colonoscopy, but is currently limited by compromised mucosal visibility because of the lack of safe, controlled colonic insufflation. We have therefore developed a novel system of untethered, wireless-controlled carbon dioxide (CO2) insufflation for use in colonic capsule endoscopy, which this study aims to assess in vivo. MATERIAL AND METHODS: This observational, nonsurvival, in vivo study used five Yorkshire-Landrace cross swine. A novel insufflation capsule was placed in the porcine colons, and we recorded volume of insufflation, time, force, visualization, and a pathologic assessment of the colon. RESULTS: The mean (standard deviation [SD]) diameter of insufflation was 32.1 (3.9)âmm. The volume of CO2 produced successfully allowed complete endoscopic visualization of the mucosa and safe proximal passage of the endoscope. Pathologic examination demonstrated no evidence of trauma caused by the capsule. CONCLUSIONS: These results demonstrate the feasibility of a novel method of controlled colonic insufflation via an untethered capsule in vivo. This technological innovation addresses a critical need in colon capsule endoscopy.
Asunto(s)
Endoscopía Capsular/métodos , Colon/patología , Colonoscopía/métodos , Insuflación/métodos , Mucosa Intestinal/patología , Animales , Endoscopía Capsular/instrumentación , Dióxido de Carbono/administración & dosificación , Colonoscopía/instrumentación , Estudios de Factibilidad , Femenino , Insuflación/instrumentación , PorcinosAsunto(s)
Endoscopía Capsular , Insuflación/métodos , Animales , Cápsulas , Dióxido de Carbono , Ácido Cítrico/química , Colon , Bicarbonato de Sodio/química , Porcinos , Agua/químicaRESUMEN
Despite clear patient experience advantages, low specificity rates have thus far prevented swallowable capsule endoscopes from replacing traditional endoscopy for diagnosis of colon disease. One explanation for this is that capsule endoscopes lack the ability to provide insufflation, which traditional endoscopes use to distend the intestine for a clear view of the internal wall. To provide a means of insufflation from a wireless capsule platform, in this paper we use biocompatible effervescent chemical reactions to convert liquids and powders carried onboard a capsule into gas. We experimentally evaluate the quantity of gas needed to enhance capsule visualization and locomotion, and determine how much gas can be generated from a given volume of reactants. These experiments motivate the design of a wireless insufflation capsule, which is evaluated in ex vivo experiments. These experiments illustrate the feasibility of enhancing visualization and locomotion of endoscopic capsules through wireless insufflation.
Asunto(s)
Endoscopios en Cápsulas , Endoscopía Capsular/instrumentación , Insuflación/instrumentación , Robótica/instrumentación , Ácido Acético/química , Animales , Bicarbonatos/química , Endoscopía Capsular/métodos , Ácido Cítrico/química , Diseño de Equipo , Estudios de Factibilidad , Intestinos/cirugía , Modelos Biológicos , Fantasmas de Imagen , Porcinos , Tecnología InalámbricaRESUMEN
Toward increasing the diagnostic ability of wireless capsule endoscopy, we propose a method to wirelessly insufflate the Gastrointestinal Tract. By increasing the viewable surface area, it appears likely that capsule-based insufflation may reduce the number of false negative diagnoses made by endoscopic capsules. Our approach to wireless insufflation is to utilize controlled phase transition of a small volume of fluid stored onboard the capsule to a large volume of gas that is then emitted into the intestine. We begin by describing experiments designed to evaluate the amount of gas a capsule must produce to have a beneficial impact on visualization in the colon. We then describe experiments evaluating how much gas can be generated from a given volume of fluid, using Hydrogen Peroxide as our working fluid. We also evaluate thermal effects of the Hydrogen Peroxide reaction. The cumulative result of these experiments is an illustration of the feasibility of carrying a sufficient volume of fluid onboard a wireless capsule to generate a beneficial enhancement in visualization of the interior of the Gastrointestinal Tract, and specifically the colon.