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September 22, 2021
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FAMCE performs equivalently to conventional gastroscopy for gastric lesion detection

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Fully automated magnetically controlled capsule endoscopy performed similarly to conventional transoral gastroscopy and may be an effective method for gastrointestinal tract examination, according to research.

“Capsule endoscopy is widely available and has become the prime modality for minimally invasive inspection and diagnosis of small bowel pathology. However, gastric examination with capsule devices remains uncommon,” Yu-Feng Xiao, MD, The Second Affiliated Hospital in Chongqing, China, and colleagues wrote. “Evidence increasingly indicates that capsule endoscopy, controlled by an external magnetic field, can be successfully used for gastroscopy. ... A third-generation system, the fully automated magnetically controlled capsule endoscopy system (FAMCE), can automatically guide a magnetic capsule with an adaptive frame to complete gastroscopy without requiring an operator to control the capsule manually.”

The rate of complete gastric anatomical structure detection by fully automated magnetically controlled capsule endoscopy was 100%

In a prospective study, researchers analyzed 114 patients (mean age 44 years; 55% women) with suspected gastric pathology to evaluate the efficacy and safety of FAMCE. Patients underwent FAMCE for gastric lesion screening first followed by conventional gastroscopy 2 hours later; the primary outcome was the rate of complete gastric anatomy landmark detection. Additional evaluated endpoints included time required for each procedure, the rate of complete small bowel examination and adverse events.

According to study results, the rate of complete gastric anatomical structure detection by FAMCE was 100% (95% CI, 99.3-100) with a concordance of 99.61% (95% CI, 99.45-99.78) between procedures. Researchers noted among 214 lesions detection by FAMCE and conventional transoral gastroscopy, 193 were detected by both screening modalities (6 pathologies missed by FAMCE vs. 16 pathologies missed by conventional screening). While the mean gastroscopy completion time was quicker using conventional transoral gastroscopy (5.21 minutes vs. 19.17 minutes, respectively), FAMCE provided complete small bowel examinations for all study patients and detected intestinal lesions among 44%. No serious adverse events or incidences of capsule retention occurred.

“FAMCE had a similar performance to conventional transoral gastroscopy in terms of gastric examination and lesion detection and also provided a complete examination of the small bowel in the same sitting,” Xiao and colleagues concluded. “With the continuing development of capsule technology, requirements for disease prevention and ongoing challenges in large-scale health-care provision, FAMCE is an additional versatile and automated tool in the field of robotic gastroscopy.”