A new capsule robot may soon take some of the discomfort out of having a colonoscopy while still providing accurate results.
Traditionally, a colonoscopy involves inserting a thin, flexible tube (the colonoscope) into a patient’s rectum while they are under sedation.
The colonoscope, which has a light and camera on the end of it, allows the doctor to get an in-depth look on an accompanying screen so they can view the large intestine to find any ulcers, tumors, polyps, or areas where there is inflammation.
Doctors typically recommend the procedure at age 50 for most people. Because you must prepare your body by not eating and taking a cleansing medication before the procedure, many people find it unpleasant.
That’s why medical professionals and researchers have been on the hunt to find alternatives to the procedure that can still ensure accurate testing.
However, those tests aren’t ideal for all patients, nor can they promise results as comprehensive as a colonoscopy.
Enter the capsule
But a new magnetized capsule colonoscope may offer a new solution for colonoscopies.
When paired with standard medical instruments, an 18-millimeter magnetized capsule colonoscope was successful at performing intricate maneuvers inside the colon.
It is guided by an external magnet that is attached to a robotic arm.
The rectally inserted capsule robot can identify and remove pre-cancerous lesions and tumors — something that’s also done during traditional colonoscopies.
The capsule robot includes a tether on the end, which can attach to biopsy and polyp removal tools.
It was able to perform retroflexion, a move that enables it to offer a reverse view of the colon wall, with just the press of a button instead of requiring the tube to bend backward.
The capsule robot pulls instead of pushes, so it can potentially reduce the risk of adverse events or the need for sedation, said Dr. Keith Obstein, a study author, and associate professor of medicine at Vanderbilt University Medical Center in Nashville, Tenn.
Currently, the colonoscope may not move into the body as much as desired, which causes it to form loops as it is inserted.
“Our system is able to pull the system from the front, thereby reducing looping and potentially adverse events,” Obstein said on a conference call.
A more comfortable exam?
While the capsule robot may not remove anxiety around the procedure, researchers say it can reduce the discomfort of the test.
Obstein said the capsule robot has the potential to improve patient acceptance of colonoscopy.
Traditional colonoscopies require air to be inserted into the colon, which can cause pressure, gas, and general discomfort.
The study was presented recently at Digestive Disease Week (DDW) 2017.
Clinicians tested the capsule robot in a pig.
There are other capsules that have been developed, but they cannot conduct biopsies that are needed to detect cancerous cells.
Obstein said they rely on passive motion, gravity, or natural movement to travel into the body, so they cannot be actively manipulated by the clinician.
The robot can be easily manipulated so doctors spend less time maneuvering it and more time being able to detect abnormalities.
Still not a “gold standard,” doctors say
Dr. Pankaj Vashi, who heads up the gastroenterology and nutrition department for Cancer Treatment Centers of America in Illinois, told Healthline the innovation may benefit apprehensive patients.
However, it can miss small polyps especially in patients who have not cleansed properly before the procedure.
While less invasive tests have benefits, he believes that “this test as of now cannot and should not replace the colonoscopy, which is still considered the ‘gold standard’ for exploration within the colon.”
As more studies are published and doctors can confirm the significance and efficacy of the technology, it may become more widely used, Vashi noted.
Dr. David Greenwald, a gastroenterologist with The Mount Sinai Hospital in New York, said the fact that the new robot can maneuver well, take biopsies, and remove polyps is an exciting innovation.
“The ability to take directed biopsies using a robot capsule as described in this pilot research would be a significant advance, and is very exciting,” Greenwald said.
But, he noted that traditional colonoscopy is the only way to completely remove precancerous polyps at this time.
“The capsule robot colonoscopy technique described in this work is very exciting and innovative,” Greenwald said. “Its role in supplanting some of what is now done by traditional colonoscopy awaits further study.”
Obstein said human trials of the capsule robot are slated to begin late next year.
His team will now work on perfecting the maneuvers and developing a platform for teaching doctors how to use the technology.
“There’s no doubt in the value of colonoscopies to keep people healthy through preventive screening for colon cancer, but many individuals still avoid this procedure, because of fear of the test itself, perceived discomfort, or the risk of sedation,” Obstein said in a statement. “We developed this capsule robot to make traversing the GI tract much easier for both the clinician and patient.”
Colorectal cancer is the second leading cancer killer in the United States, according to the Centers for Disease Control and Prevention (CDC).