Endoscopy 2019; 51(04): S254
DOI: 10.1055/s-0039-1681937
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Stomach and small intestine ePosters
Georg Thieme Verlag KG Stuttgart · New York

DEVELOPMENT AND FEASIBILITY OF A METHOD TO IMPROVE THE DIAGNOSTIC VALUE OF MAGNETICALLY ASSISTED CAPSULE ENDOSCOPY IN THE DETECTION OF ESOPHAGEAL DISORDERS

B Dorottya Lovasz
1   Semmelweis University, Budapest, Hungary
,
Z Dubravcsik
2   Bacs-Kiskun County Hospital, Kecskemet, Hungary
,
K Zsobrak
3   Endo-Kapszula Endoscopy Unit, Szekesfehervar, Hungary
,
M Szalai
3   Endo-Kapszula Endoscopy Unit, Szekesfehervar, Hungary
,
P Schmiedt
3   Endo-Kapszula Endoscopy Unit, Szekesfehervar, Hungary
,
L Madacsy
3   Endo-Kapszula Endoscopy Unit, Szekesfehervar, Hungary
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Esophageal disorders, especially reflux esophagitis and Barrett's esophagus are common diseases. The non-invasive visualization of the esophagus is not solved yet. Esophagogastroduodenoscopy (EGD) is the gold standard diagnostic test, however it is uncomfortable for patients without sedation. The aim of the current study was to develop a method with magnetically assisted capsule endoscopy (MACE) for esophageal investigation and to perform a feasibility study of its use in patients.

Methods:

We developed a method for stationing the MACE capsule in the distal esophagus. First an ex vivo artificial esophagus was prepared and tested to find the optimal position and parameter settings to restrain the MACE capsule approximately 5 cm above the cardia. After the ex vivo development phase, we performed a feasibility study in 20 volunteers (median age: 47.65 years; 60% female; all had both MACE and EGD examinations within 3 months). All patients were laid on their left side, the upper body was raised 45 degrees with the examining table. The magnetic C-arm of MACE system was positioned next to their backs and the magnetic vector was positioned 90 °and -90 ° to hold the capsule perpendicular to the esophageal lumen. We recorded every examination, both MACE and EGD, and analyzed the videos independently.

Results:

With our new protocol we could restrain the capsule in the esophagus in 90% of the cases (18/20). Esophageal transit and visualization times were 91.9 s with MACE and 46.2 s with EGD on average. The diagnostic abnormalities with EGD and MACE were comparable, while the diagnostic yield with UGE was higher than MACE regarding minor reflux erosions (12/6).

Conclusions:

Our protocol is a promising method to investigate the esophagus non-invasively with MACE to exclude major pathology in low risk groups. Further capsule development (cameras on both end, higher frame rate, higher resolution) may improve the diagnostic accuracy of this method.