A traditional endoscopy, while valuable for detecting high-risk lesions, is an expensive, invasive procedure. There are ingestible cameras but are not controlled by physicians, they are just swallowed and the body does the rest.

A pilot study brings remote ones closer to the original kind. Physicians can remotely drive a miniature video capsule to all regions of the stomach to visualize and photograph potential problem areas. The new technology uses an external magnet and hand-held video game style joysticks to move the capsule in three-dimensions in the stomach, nearing the capabilities of a traditional tube-based endoscopy, which are used 7 million times per year to investigate and treat stomach pain, nausea, bleeding and other symptoms of disease, including cancer. 

Professor Andrew Meltzer of George Washington University says this can bridge gaps created by the Affordable Care Act. In dozens of states like California, the first question a doctor's staff asks is if you are on insurance through the Exchange. Many will only accept a limited number of Obamacare patients and the wait can be long. That leaves emergency rooms, where a patient with stomach pain or suspected upper GI bleeding can't get an endoscopy.


AnX Robotica's capsule endoscopy system: NaviCam. Credit: AnX Robotica

The study is the first to test magnetically controlled capsule endoscopy in the United States. If it checks out, the ability to swallow a capsule, use an external magnet to guide the capsule and visualize all anatomic areas of the stomach and record video and photograph any possible bleeding, inflammatory or malignant lesions - without a new appointment for a traditional endoscopy – is a real plus.

The controller requires time and training but machine learning (colloquially called "AI") can eventually do that. The videos can then be transmitted for off-site review if a gastroenterologist is not on-site to over-read the images. 

In 40 patients, they found that the doctor could direct the capsule to all major parts of the stomach with a 95 percent rate of visualization. Capsules were driven by the ER physician and then the study reports were reviewed by an attending gastroenterologist who was physically off-site. Participants also received a follow up endoscopy. No high-risk lesions were missed with the new method and 80 percent of the patients preferred the capsule method to the traditional endoscopy. The team found no safety problems associated with the new method.