Robotic Technology Could Allow Colonoscopy to Be Performed Through Autonomous Capsule

At Digestive Disease Week 2017, held May 6-9 in Chicago, Illinois, researchers presented their work to develop a capsule robot that can harness the power of magnetics to autonomously explore the colon.

The scope device is a capsule 18 by 21 millimeters in diameter, which tapers to a 6.5 millimeter tether. The capsule contains a magnet and software that can detect its own position in relation to an external robotic arm, which allows for precise, autonomous movement throughout the colon. Study co-author Keith Obstein, MD, associate professor of medicine at the Vanderbilt Institute for Surgery and Engineering, referred to the system as a “magnetic actuated colonoscope” in an interview with reporters, including The American Journal of Managed Care^®.

Traditionally, colonoscopies are performed by pushing the scope forward from the back, which can cause the tether to loop in the colon and potentially cause discomfort or tears in the colon. The new capsule robot is instead “pulled” from the head through the magnetic force of an automatically controlled robotic arm outside the body, which can lead to a smoother, more precisely controlled journey throughout the colon, according to Obstein.

Another exciting feature of the capsule robot is its ability to perform retroflexion, a maneuver “where the front of the endoscope basically turns around on itself to look backwards,” Obstein said. This is a fully autonomous system, meaning that “a button is pushed, our algorithms are engaged, and the capsule will rotate on its own.”

The next step for the researchers will be to achieve teleoperation, which allows the operator to control the capsule’s movement from the perspective of being inside the capsule. Obstein explained that this would allow the clinician to “solely concentrate on the colon itself and the identification of suspicious lesions or areas of interest, and in the background our algorithms are running to make that happen.”

Although trials of the system have only been performed so far in pigs, the researchers are optimistic about its performance in human trials, which they hope to have underway in about 18 months. “The porcine model is commonly used in gastroenterology, especially with sort of new devices or technologies,” Obstein explained. “We think that it will translate nicely into our first human trials.”

As mentioned before, the pulling rather than pushing mechanism of the scope could result in reduced discomfort and potential adverse events. The ultimate goal is to perform the procedure “without the need for sedation, solely by changing the dynamics of how the scope is advanced,” Obstein said.

This could have a number of important implications, as it may potentially reduce some of the barriers to colon cancer screening, like the risks of sedation and the need for a patient and driver to take a day off from work, which Obstein said “can potentially make it a little more patient-friendly” and ultimately increase screening rates. It would also significantly benefit patients with inflammatory bowel disease, who must undergo colonoscopy every year and are therefore more likely to experience adverse events in their lifetime based on the sheer number of procedures. Furthermore, Obstein hopes that the cost savings from eliminating the need for sedation and the associated time spent in the clinic would eventually outweigh the initial cost of the robotic arm.

“We’re very excited about this,” Obstein concluded. “I think what really launched us as far as continued optimism is the fact that we were able to successfully do automation with it, which demonstrates the robustness of the algorithms and the control mechanisms that we’re using.”