New pill-cam technology provides safer, more comprehensive GI probes without sedation
“I’m a scientific skeptic but also an early adopter. I like medical technology that takes us to the next level,” said Dr. R. Matthew Reveille, Rocky Mountain Regional VA Medical Center section chief of gastroenterology and hepatology.
New technology
That next-level tech is the NaviCam, a device that uses a magnetically controlled capsule to allow clinicians to diagnose upper gastrointestinal conditions without sedation.
Reveille said RMR is the second VA in the U.S. to have this Food and Drug Administration-approved technology. NaviCam procedures will be conducted by specially trained GI nurses, which should begin by year’s end.
How medical data is collected
Dr. Reveille explained the process.
“Patients fast after midnight; so just eight hours,” he said. “They come in and swallow the capsule, similar in size to a large vitamin pill, but it has a metal casing. Patients then drink 1.2-1.4 liters of water and lie on a special table underneath a magnetic boom. The capsule’s position and movement can be directed by the magnet.”
During the procedure, patients wear a vest that records transmissions from the NaviCam capsule.
Benefits of this tech
Reveille said RMR’s GI department used pill-cam tech in the past, but they needed the device to be steerable and controllable. NaviCam made that possible.
“A magnet controls it so you can steer it around with a joystick,” Reveille said. “It’s like an old Atari machine.”
NaviCam also allows GI clinicians to examine a patient’s entire esophagus and stomach.
“Former pill-cams moved through the digestive system as food does, with no way to control its movement,” said Reveille. “We had to do procedures over two days and use the images in tandem, but we still couldn’t see the top of stomach and it went through the esophagus too fast.”
When examining a patient’s esophagus using NaviCam, the capsule is attached to a string, so clinicians can control how fast it goes down and they can even pull it back up for another look, if needed.
Image transmission is delayed only a few seconds, so images are readable in real time on a monitor. The procedure takes about 18-20 minutes, much less time than an endoscopy requiring anesthesia.
The NaviCam pill has a four-hour battery. Once all needed medical data is recorded, the capsule passes out of the patient’s body with normal bowel movement.
Safer without sedation
Since the device can survey a GI tract without having to put the patient to sleep, Reveille said they plan to use NaviCam on Veterans, in three target groups, who are at high risk for sedation.
“Patients with cirrhosis of the liver; advanced cardiac disease or COPD with no implants; and bariatric patients with BMI over 35, due to a higher potential for having a restricted airway,” he said. “We’ll start with those groups.”
Not for everyone
The magnet used with NaviCam has only 10-20% of the strength of an MRI, but Veterans with implantable devices, such as a pacemaker, cannot get the procedure.
For more information about this technology, consult your GI team at VA.
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April Love is a Writer-Editor on the VISN 19 Creative Task Force. She began working for Denver VA in 2016 and lives in Aurora, Colorado.