No abstract

An innovative approach to active locomotion for capsular endoscopy in the gastric district is reported in this paper. Taking advantage of the ingestion of 500 ml of transparent liquid by the patient, an effective distension of the stomach is safely achieved for a timeframe of approximately 30 minutes. Given such a scenario, an active swallowable capsule able to navigate inside the stomach thanks to a four propeller system has been developed. The capsule is 15 mm in diameter and 30 mm in length, and it is composed of a supporting shell containing a wireless microcontroller, a battery and four motors. The motors enable the rotation of propellers located in the rear side of the device, thus obtaining a reliable locomotion and steering of the capsule in all directions in a liquid. The power consumption has been properly optimized in order to achieve an operative lifetime consistent with the time of the diagnostic inspection of the gastric district, assumed to be no more than 30 minutes. The capsule can be easily remotely controlled by the endoscopist using a joystick together with a purposely developed graphical user interface. The capsule design, prototyping, in vitro, ex vivo and preliminary in vivo tests are described in this work.

HRV analysis revealed a distinct impact of VNS for CIONM on ANS balance. VNS caused parasympathetic predominance that was not countered by increased sympathetic activity.

VNS for CIONM resulted in increased vagal activity assessable via HRVA. The increased parasympathetic tone affected neither hemodynamics nor levels of the proinflammatory cytokine TNF-α. VNS for CIONM appears safe with the applied settings.