Magnetically controlled delivery capsule endoscopy for precise drug delivery to intestinal lesions

Current drug delivery devices can't deliver drugs toward targeted intestinal lesions non-invasively. A novel magnetically controlled delivery capsule endoscopy (MDCE) system was developed to accurately deliver topical therapy toward intestinal lesions under real-time optical visualization. We aimed to evaluate the feasibility and efficacy of this MDCE system in precisely targeted delivery of topical therapy. The delivery feasibility of the MDCE were first evaluated using an ex vivo swine intestinal model. In this model, simulated lesions (n = 27) were created and marked with a pre-selected dye (0.1% methylene blue). The MDCE delivery processes for small intestine lesions were conducted in four Bama miniature pigs. The feasibility of MDCE was defined as successful drug delivery to specific simulated small bowel lesion under optical surveillance. Efficacy was evaluated using parameters including image quality, maneuverability of the MDCE, and the time required for aiming and drug delivery taken by MDCE. The MDCE system demonstrated robust feasibility in an ex vivo intestinal model, achieving over 80% targeting success rate across 27 lesions at various orientations. This precision was successfully translated in vivo, with 91.7% (22/24) of target lesions precisely stained. Except for two raised lesions, 22 of them were precisely stained. The image quality and the maneuverability of the MDCE system were both graded as the best. Further analysis of procedural efficiency revealed that while the time for aiming lesions (16 s to 191 s) was longer in the small intestine than in the colon, especially when aiming at flat lesions (p = 0.0304), the rapid dye delivery time (4 s to 11 s) remained consistent across all locations and lesion types (p > 0.05). This study confirmed the feasibility and efficacy of the MDCE system for delivering targeted drug to specific intestinal lesions with real-time, vision-based monitoring in swine models.