Controlled colonic insufflation by a remotely triggered capsule for improved mucosal visualization.
OBJECTIVE
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.


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) mm. 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.
School of Medicine, Vanderbilt University, Nashville, Tennessee, United States.
Trisha
T
Pasricha
Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee, United States.
Byron F
BF
Smith
Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee, United States.
Victoria R
VR
Mitchell
Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee, United States.
Brian
B
Fang
Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, Tennessee, United States.
Erik R
ER
Brooks
Division of Chemical Engineering, Vanderbilt University, Nashville, Tennessee, United States.
Jason S
JS
Gerding
Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, Tennessee, United States.
Mary Kay
MK
Washington
Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee, United States.
Pietro
P
Valdastri
Division of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
Keith L
KL
Obstein
D000818:Animals; D053704:Capsule Endoscopy / Q000295:instrumentation / Q000379:methods*; D002245:Carbon Dioxide / Q000008:administration & dosage; D003106:Colon / Q000473:pathology*; D003113:Colonoscopy / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D007327:Insufflation / Q000295:instrumentation / Q000379:methods*; D007413:Intestinal Mucosa / Q000473:pathology*; D013552:Swine
D002245:Carbon Dioxide