No abstract

The results from a novel automated real-time colonoscopy quality feedback system strongly agreed with the endoscopists' quality assessments. Further study is required to validate this approach.

Transcutaneous intraluminal impedance measurement (TIIM) is a new method to cutaneously measure gastric contractions by assessing the attenuation dynamics of a small oscillating voltage emitted by a battery-powered ingestible capsule retained in the stomach. In the present study, we investigated whether TIIM can reliably assess gastric motility in acute canine models. Methods. Eight mongrel dogs were randomly divided into 2 groups: half received an active TIIM pill and half received an identically sized sham capsule. After 24-hour fasting and transoral administration of the pill (active or sham), two force transducers (FT) were sutured onto the antral serosa at laparotomy. After closure, three standard cutaneous electrodes were placed on the abdomen, registering the transluminally emitted voltage. Thirty-minute baseline recordings were followed by pharmacological induction of gastric contractions using neostigmine IV and another 30-minute recording. Normalized one-minute baseline and post-neostigmine gastric motility indices (GMIs) were calculated and Pearson correlation coefficients (PCCs) between cutaneous and FT GMIs were obtained. Statistically significant GMI PCCs were seen in both baseline and post-neostigmine states. There were no significant GMI PCCs in the sham capsule test. Further chronic animal studies of this novel long-term gastric motility measurement technique are needed before testing it on humans.

The stomach plays a critical role in digestion, processing ingested food mechanically and breaking it up into particles, which can be effectively and efficiently processed by the intestines. When the motility of the stomach is compromised, digestion is adversely affected. This can lead to a variety of disorders. Current diagnostic techniques for gastric motility disorders are seriously lacking, and are based more on eliminating other possibilities rather than on specific tests. Presently, gastric motility can be assessed by monitoring gastric emptying, food transit, intragastric pressures, etc. The associated tests are usually stationary and of relatively short duration. The present study proposes a new method of measuring gastric motility, utilizing the attenuation of an oscillator-induced electrical signal across the gastric tissue, which is modulated by gastric contractions. The induced high-frequency oscillator signal is generated within the stomach, and is picked up transluminally by cutaneous electrodes positioned on the abdominal area connected to a custom-designed data acquisition instrument. The proposed method was implemented in two different designs: first a transoral catheter was modified to emit the signal inside the stomach; and second, a gastric retentive pill was designed to emit the signal. Both implementations were applied in vivo on two mongrel dogs (25.50 kg and 25.75 kg). Gastric contractions were registered and quantitatively compared to recordings from force transducers sutured onto the serosa of the stomach. Gastric motility indices were calculated for each minute, with transluminal impedance measurements and the measurements from the force transducers showing statistically significant (p < 0.05) Pearson correlation coefficients (0.65 ± 0.08 for the catheter-based design and 0.77 ± 0.03 for the gastric retentive pill design). These results show that transcutaneous intraluminal impedance measurement has the potential with further research and development to become a useful diagnostic technique.

Video capsule endoscopy (VCE) is a noninvasive method for examining the gastrointestinal tract which has been successful in small intestine studies. Recently, VCE has been attempted in the colon. However, the capsule often tumbles in the wider colonic lumen, resulting in missed regions. Self-stabilizing VCE is a novel method to visualize the colon without tumbling. The aim of the present study was to comparatively quantify the effect of stabilization of a commercially available nonmodified capsule endoscope (CE) MiroCam and its modified self-stabilizing version in acute canine experiments. Two customized MiroCam CEs were reduced in volume at the nonimaging back-end to allow the attachment of a self-expanding, biocompatible stabilizing device. Four mongrel dogs underwent laparotomy and exteriorization of a 15-cm segment of the proximal descending colon. A single CE, either self-stabilizing or nonmodified was inserted through an incision into the lumen of the colon followed by pharmacologically induced colonic peristalsis. The inserted capsule was propelled distally through the colon and expelled naturally through the anus. Novel signal processing method was developed to quantify the video stabilization based on camera tracking a predetermined target point (locale). The average locale trajectory, the average radius movement of the locale, and the maximum rate of change of the locale for sequential images were significantly lower for the stabilized capsules compared to the nonstabilized ones . The feasibility of self-stabilized capsule endoscopy has been demonstrated in acute canine experiments.