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| Name | Class |
|---|---|
| The Cleveland Clinic | OTHER |
| AnX Robotica Corp. | INDUSTRY |
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The goal of this clinical trial is to test if a swallowable camera capsule can safely examine the upper digestive tract in people preparing for weight loss surgery. The camera capsule (called NaviCam® Xpress™ Stomach System) is controlled by magnets from outside the body and doesn't require sedation, unlike traditional endoscopy. The main questions it aims to answer are:
Can the camera capsule be safely used in people with a body mass index (BMI) greater than 38? Can doctors successfully control and move the camera capsule to see the necessary areas of the stomach and esophagus? Researchers will evaluate 30 participants who are preparing for weight loss surgery.
Participants will:
Swallow the camera capsule with water after not eating or drinking since midnight Have their upper digestive tract examined while the doctor controls the capsule from outside their body Complete a brief satisfaction survey about their experience Be followed up with a phone call 2-3 weeks after the procedure
This study could help determine if the camera capsule is a good alternative to traditional endoscopy for people preparing for weight loss surgery, potentially avoiding the need for sedation.
Detailed Description:
The NaviCam® Xpress™ Stomach System represents a novel approach to upper gastrointestinal visualization in the bariatric surgery population. This magnetically controlled capsule endoscopy (MCCE) system consists of a single-use wireless capsule that contains imaging components and magnetic materials that allow external control through a physician-operated magnet.
Technical Specifications and Procedure:
The capsule is equipped with cameras capable of capturing both still images and continuous video footage. After the patient swallows the capsule with 500ml of water, it initially descends the esophagus via natural peristalsis while continuously recording. The capsule is initially attached to a tether, which is released via a 15ml air injection mechanism once the capsule reaches the appropriate position. Once inside the stomach, the external magnetic control system allows the physician to systematically manipulate the capsule's position and orientation, enabling thorough visualization of the gastric mucosa.
Clinical Significance:
This study addresses a critical gap in pre-bariatric surgery evaluation. While traditional esophagogastroduodenoscopy (EGD) remains the gold standard, it presents unique challenges in the bariatric population due to:
Increased sedation risks associated with high BMI Higher technical complexity of the procedure Greater risk of respiratory complications during sedation
Innovation and Technological Advancement:
This represents one of the first applications of MCCE technology specifically targeted at the bariatric surgery population. The study's focus on patients with BMI >38 kg/m² will provide valuable data about the system's performance in body habitus previously considered challenging for magnetic control systems.
The feasibility assessment incorporates multiple technical parameters:
Magnetic control responsiveness across varying body habitus Quality of mucosal visualization in different anatomical regions System reliability and technical performance metrics Procedure duration and technical success rates
This study will help establish the potential role of MCCE in the standard pre-bariatric surgery evaluation pathway and may inform future technological refinements specific to this patient population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Magnetically Controlled Capsule Endoscopy (MCCE) Arm | Experimental | Participants will undergo preoperative upper gastrointestinal tract evaluation using the NaviCam® Xpress™ Stomach System, a magnetically controlled capsule endoscopy device. After fasting overnight, participants will swallow the capsule with 500ml of water. The capsule will initially be tethered and will capture images as it descends the esophagus. Once positioned appropriately, the tether will be released via 15ml air injection, and the surgeon will control the capsule's movement in the stomach using an external magnetic control system. All participants will be followed for 14-21 days post-procedure. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Magnetically Controlled Capsule Endoscopy (MCCE) | Device | The intervention consists of a wireless capsule containing cameras and magnetic materials that enable external control. After overnight fasting, participants swallow the capsule with 500ml of water. The capsule is initially tethered and captures images as it descends the esophagus. Once appropriately positioned, the tether is released by injecting 15ml of air. A trained surgeon then controls the capsule's movement within the stomach using an external magnetic control system, allowing systematic visualization of the upper gastrointestinal tract mucosa. The procedure is performed without sedation and takes place at the Main Campus M60 facility. The capsule naturally passes through the digestive system after the examination. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants with Successful Magnetic Control of the Capsule | Successful magnetic control is defined as the ability of the NaviCam Xpress Stomach System to be moved as intended and controlled by the surgeon to all target anatomical regions. Reported as the number of participants in whom successful magnetic control was achieved. | From enrollment to the end of interpretation of the MCCE images, approximately 20 days. |
| Number of Participants with Adequate Visualization of the Esophageal and Gastric Mucosa | Adequate visualization is defined as the NaviCam Xpress Stomach System providing satisfactory imaging of the esophageal and gastric mucosa as assessed by the operating surgeon. Reported as the number of participants in whom adequate visualization was achieved. | From enrollment to the end of interpretation of the MCCE images, approximately 20 days. |
| Number of Participants Completing MCCE Without Conversion to Conventional Endoscopy | Defined as successful completion of the magnetically controlled capsule endoscopy procedure without the need for conversion to a conventional esophagogastroduodenoscopy (EGD). Reported as the number of participants who completed the procedure without conversion. | From enrollment to the end of interpretation of the MCCE images, approximately 20 days. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants with Device Failure | Defined as device breakage or malfunction requiring additional surgical intervention, including reoperation and/or device removal. Reported as the number of participants experiencing device failure. | From enrollment to the end of interpretation of the MCCE images, approximately 20 days. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jerry Dang, MD, PhD | The Cleveland Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cleveland Clinic Foundation | Cleveland | Ohio | 44195 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38230854 | Result | Scott J, Blackhurst D, Hodgens BD, Carbonell AM, Cobb WS, Richardson ES, Dahlgren NJ, Kothari SN. Use of Preoperative Endoscopic Capsule-Based pH Testing Before Bariatric Surgery. J Am Coll Surg. 2024 Apr 1;238(4):551-558. doi: 10.1097/XCS.0000000000000974. Epub 2024 Mar 15. |
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| ID | Term |
|---|---|
| D009765 | Obesity |
| D006973 | Hypertension |
| D003920 | Diabetes Mellitus |
| ID | Term |
|---|---|
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D004724 | Endoscopy |
| ID | Term |
|---|---|
| D003949 | Diagnostic Techniques, Surgical |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D019060 | Minimally Invasive Surgical Procedures |
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The study will enroll 30 consecutive eligible patients who are preparing for bariatric surgery. This sample size was specifically chosen based on current recommendations in the literature for pilot feasibility studies. All participants will undergo the same MCCE procedure using the NaviCam® Xpress™ Stomach System at the Main Campus M60 facility.
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| Number of Participants with Serious Adverse Events Probably or Definitely Related to the Device |
Defined as any serious adverse event probably or definitely related to the device, including revision or removal of the device, permanent damage to the organ, or death of the study subject. Reported as the number of participants experiencing a device-related serious adverse event. |
| From enrollment to 14-21 days post-procedure. |
| D001835 |
| Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D013514 | Surgical Procedures, Operative |