Feasibility proof of a legged locomotion capsule for the GI tract

Background: A colonoscopy and a gastroscopy are the most important screening measures for malignant diseases in the GI tract. One of the main limitations is the lack of patient adherence to come in for a flexible endoscopy, especially in asymptomatic conditions. Objective: The feasibility proof of a new generation of endoscopic capsules based on a novel propelling mechanism that features electromechanical legs. Design: Teleoperated endoscopic 8-legged capsule. Setting: Scuola Superiore Sant'Anna, Pisa, Italy, and novineon Healthcare Technology Partners GmbH, Tubingen, Germany. Main Outcome Measurements: Successful locomotion in a lower-GI tract (LGI) phantom model and in a porcine colon. Results: The testing session was organized into repetitive ex vivo trials and in vivo tests. The repetitive tests were performed for collecting reproducible data in various small series of individual experiments in standardized conditions, thus defining the best locomotion parameters. In vivo tests were performed in a porcine colon: the capsule, inserted transanally, traveled upward in the oral direction for 15 cm in about 5 minutes, against peristalsis. Limitations: The current version of the capsule travels curves by bouncing back from the wall and following step by step the direction of the curved bowel. Steering mechanisms are not yet implemented. Conclusions: This study shows the systematic development and medical assessment of an imaging capsule with self-propelling abilities. A full colonic passage was successfully demonstrated in the ex vivo phantom model. A net movement in in vivo tests has been achieved, thus giving a feasibility proof of the legged locomotion as a possible solution to the problem of self-locomoting endoscopic devices in the LGI.