key: cord-0685950-7y43iw04
authors: Pan, Jun; Li, Zhaoshen; Liao, Zhuan
title: Noncontact endoscopy for infection-free gastric examination during the COVID-19 pandemic
date: 2020-05-08
journal: VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy
DOI: 10.1016/j.vgie.2020.04.026
sha: 70490193e2f1eec7c39f0360128873ea00748f1e
doc_id: 685950
cord_uid: 7y43iw04

nan

During the COVID-19 pandemic, direct contact between medical staff and patients in clinical practice, eg, endoscopy procedures, bears potential risk of infection. Telemedicine, or noncontact medicine, in this circumstance offers an ideal solution. 1, 2 Here we report the first clinical experience of remote controlling capsule endoscopy for gastric examination.

The novel noncontact magnetically controlled capsule endoscopy (MCE) system (Ankon Technologies, China) (Fig. 1 ) added a remote control workstation and an audiovisual exchange system to the original well-established MCE system, which consisted of a robotic magnetic arm, a workstation (currently bypassed) and a capsule endoscope, 3 and boasted a 90% sensitivity and a 94% specificity for diagnosing gastric focal lesions. [4] [5] [6] Study subjects were consecutively enrolled from March 16 to March 26, 2020. After an overnight fasting and drinking 800 to 1000 mL water and simethicone for gastric dilatation and preparation, the study subject positioned him/herself on the examination bed in Room A (Fig. 1A) , while the operating doctor sat in Room B at the remote control workstation (Fig. 1B) instructing him/her to swallow the capsule via the audiovisual exchange system. After the capsule entered the stomach, the doctor manipulated the 2 joysticks on the remote-control workstation, mobilizing the robotic magnetic arm, and simultaneously driving the precise movement and rotation of the capsule (Video 1).

Five subjects (2 males and 3 females) were enrolled for noncontact MCE examination, with a median age of 75 years (range, 23-80 years) (Supplementary Table 1 ). The maneuverability of the remote control MCE system was rated as excellent by the doctor (5/5, 100%), and the capsule completely observed the gastric cardia, fundus, body, angulus, antrum, and pylorus in all of the subjects, yielding cardia gastric cancer (n=1), gastric polyps (n=1), gastric erosion (n=1), and normal gastric mucosa (n=2) (Fig. 2) . Study subjects had no discomfort during and after the examination. 2 This provides a novel noncontact (infection-free) diagnostic modality for gastrointestinal diseases (eg, GI bleeding and gastric cancer) during the COVID-19 pandemic for protecting both medical staff (remote controlling, reading, and reporting) and patients (disposable capsule). Of note, signal transmission between rooms could be realized via either cable or fifth-generation (5G) communications. The remote-control endoscopy system could be more generalized to public health emergencies and even disasters where noncontact medicine is warranted. 

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