title: Magnetic-assisted capsule endoscopy in the upper GI tract by using a novel navigation system (with video).
abstract: OBJECTIVE
  Capsule endoscopy for visualization of the upper GI tract has thus far been experimental and potentially expensive. Our aim was to demonstrate the maneuverability and evaluate the ability to completely visualize and maintain views in the upper GI tract by using a simple magnetic-assisted capsule endoscopy (MACE) system.
  
  
  METHODS
  Twenty-six volunteers were recruited. The hand-held magnet was placed at strategic points on the body surface and rotated to hold and maneuver the capsule. The ability to view the upper GI tract landmarks was noted: esophagogastric junction (EGJ), cardia, fundus, body, incisura, antrum, and pylorus. Control was assessed by the ability to hold the capsule for 1 minute at 5 positions: the lower esophagus and 4 designated positions in the proximal and distal stomach and also traversing the stomach and through the pylorus. Volunteers subsequently underwent a standard gastroscopy.
  
  
  RESULTS
  The median data are as follows: age, 38 years (range 26-45 years); BMI, 24 (range 19-38); and procedure time, 24 minutes (range 12-39 minutes). Successful visualization of each landmark was EGJ, 92%; cardia, 88%; fundus, 96%; body, 100%; incisura, 96%; antrum, 96%; and pylorus, 100%; with fewer clear views of the EGJ and fundus. The capsule could be held in 88% of designated positions for 1 minute, moved from the fundus to the antrum in all cases, and traversed the pylorus in 50% (n = 13). An age of 40 years and older was associated with successful pyloric traversing (P = .04). There was positive concordance for 8 of 9 minor pathological findings on standard gastroscopy.
  
  
  CONCLUSIONS
  MACE in the upper GI tract is feasible. There is a high degree of visualization and control, with some improvement required for optimizing proximal gastric views and traversing the pylorus.
authors.affiliation: Department of Gastroenterology, University Hospital Southampton, Southampton, United Kingdom.
authors.forename: Imdadur
authors.initials: I
authors.lastname: Rahman
authors.affiliation: Gastroenterology and Digestive Endoscopy Unit, Pavilion H, Hôpital Edouard Herriot, Lyon, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Pioche
authors.affiliation: Digestive Disease Center, Konkuk University Medical Center, Seoul, South Korea.
authors.forename: Chan Sup
authors.initials: CS
authors.lastname: Shim
authors.affiliation: Digestive Disease Center, Konkuk University Medical Center, Seoul, South Korea.
authors.forename: Sang Pyo
authors.initials: SP
authors.lastname: Lee
authors.affiliation: Digestive Disease Center, Konkuk University Medical Center, Seoul, South Korea.
authors.forename: In-Kyung
authors.initials: IK
authors.lastname: Sung
authors.affiliation: Gastroenterology and Digestive Endoscopy Unit, Pavilion H, Hôpital Edouard Herriot, Lyon, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Saurin
authors.affiliation: Department of Gastroenterology, University Hospital Southampton, Southampton, United Kingdom.
authors.forename: Praful
authors.initials: P
authors.lastname: Patel
mesh_terms: D000328:Adult; D053704:Capsule Endoscopy / Q000295:instrumentation* / Q000379:methods; D002299:Cardia / Q000000981:diagnostic imaging; D004943:Esophagogastric Junction / Q000000981:diagnostic imaging; D004947:Esophagus / Q000000981:diagnostic imaging*; D005748:Gastric Fundus / Q000187:drug effects; D005756:Gastritis / Q000000981:diagnostic imaging; D005773:Gastroscopy; D064368:Healthy Volunteers; D006801:Humans; D059346:Magnets; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum / Q000000981:diagnostic imaging; D013270:Stomach / Q000000981:diagnostic imaging*