Feasibility of Upper Gastrointestinal Examination in Home Care Setting with a Magnetically Assisted Capsule Endoscopy System: A Retrospective Study

Abstract

The magnetic assisted capsule endoscope (MACE) with a hand-held magnetic field navigator (MFN) for upper gastrointestinal examination achieved satisfactory results in a healthy volunteer study. We evaluated the feasibility of upper gastrointestinal examination in the home care setting with the MACE system. Home care patients with upper gastrointestinal symptoms that received an MACE exam were enrolled in the study. MACE procedure time; completeness of observation of important anatomical landmarks; endoscopic diagnosis; patient tolerance during the procedure; and patient data, including age, sex, comorbidities, symptoms, body weight, and height, were retrieved from hospital information system for data analysis. A total of 16 participants were enrolled with a mean age 74.3 ± 15.4 years (47 to 99 years). One patient failed to swallow the capsule and was excluded. The average procedure time was 23.7 ± 10.0 min (14.1 to 42.5 min) to complete each endoscopic exam for the remaining 15 patients. The overall maneuverability in the esophagus, stomach, and duodenum was 93.75%, 87.5%, and 75%, respectively. Overall completeness in the aforementioned regions was 93.75%, 81.25%, and 75%, respectively. No severe adverse events were noted. The results clearly demonstrate the promise of using this MACE system to perform endoscopic examination outside the hospital for patients confined to the community and home.

Clinical Benefits and Challenges in Application of Novel Portable Gastric Capsule Endoscopy for Home Healthcare Patients

“…Several studies have addressed this issue based on different capsule models [ 11 , 12 , 13 , 18 ]; however, no head-to-head or direct comparison study has been conducted for conventional EGD and InsightEyes ® capsule endoscopy system. The completeness of observing upper GI tracts was 93.75% for esophagus, 81.25% for stomach, and 75.00% for the duodenum in a previous small study for a similar population [ 4 ].…”

“…Note: Pictures ( g , i ) were adapted from a previously published article with an overlapping study population with permission adapted from Ref. [ 4 ]. 2021, Lin, Y.-C.…”

“…Portable gastric capsule endoscopy with a handheld magnetic navigator, also known as magnetic-assisted capsule endoscopy (MACE), has been an alternative for providing upper gastrointestinal examinations for in-home patients since 2020 [ 4 ]. Incorporation of MACE for home healthcare patients is important due to the huge demand for home healthcare service in an aged society.…”

“…Moreover, patients benefit from less discomfort, easier swallowing, anesthesia-free treatment, and no risk of cross-infection when receiving MACE compared to conventional EGD. Based on its portability and convenience, application of MACE for aged and disabled in-home patients has been carried out in Taiwan since 2020 [ 4 ], showing that portable MACE is a feasible alternative for in-home patients to receive upper GI endoscopy at home with adequate safety and accessibility and acceptable accuracy compared to that of conventional EGD in the hospital. However, some issues regarding the MACE expense, time consumption due to traffic, physician labor, and patient experience have been noted, and these factors may affect the application of portable MACE in a larger scale of population.…”

Capsule Endoscopy for Gastric Evaluation

“…The authors observed that it was possible to capture a greater number of images at specific sites because a greater number of frames were captured per second, and this method facilitated accurate manipulation owing to the traction of the cable. Lin et al [28] performed MCE using this same device in 15 elderly patients with gastric symptoms (dyspepsia, acid reflux, heartburn, epigastric pain, or anorexia). Owing to its portability, out-of-hospital MCE could be performed and home visits were possible.…”