ORIGINAL ARTICLE: Experimental Endoscopy Active locomotion of a paddling-based capsule endoscope in an in vitro and in vivo experiment (with videos) Hee Man Kim, MD,* Sungwook Yang,* Jinseok Kim, PhD, Semi Park, MD, Jae Hee Cho, MD, Jeong Youp Park, MD, Tae Song Kim, PhD, Eui-Sung Yoon, PhD, Si Young Song, MD, PhD, Seungmin Bang, MD Seoul, Korea Background: Capsule endoscopy that could actively move and approach a specific site might be more valuable for the diagnosis or treatment of GI diseases. Objective: We tested the performance of active locomotion of a novel wired capsule endoscope with a paddling-based locomotion mechanism, using 3 models: a silicone tube, an extracted porcine colon, and a living pig. Design: In vitro, ex vivo, and in vivo experiments in a pig model. Setting: Study in an animal laboratory. Interventions: For the in vitro test, the locomotive capsule was controlled to actively move from one side of a silicone tube to the other by a controller-operated automatic traveling program. The velocity was calculated by following a video recording. We performed ex vivo tests by using an extracted porcine colon in the same manner we performed the in vitro test. In in vivo experiments, the capsule was inserted into the rectum of a living pig under anesthesia, and was controlled to move automatically forward. After 8 consecutive trials, the velocity was calculated. Main Outcome Measurements: Elapsed time, velocity, and mucosal damage. Results: The locomotive capsule showed stable and active movement inside the lumen both in vitro and ex vivo. The velocity was 60 cm/min in the silicone tube, and 36.8 and 37.5 cm/min in the extracted porcine colon. In the in vivo experiments, the capsule stably moved forward inside the colon of a living pig without any serious complications. The mean velocity was 17 cm/min over 40 cm length. We noted pinpoint erythematous mucosal injuries in the colon. Limitation: Porcine model experiments, wired capsule endoscope. Conclusions: The novel paddling-based locomotive capsule endoscope performed fast and stable movement in a living pig colon with consistent velocity. Further investigation is necessary for practical use in humans. ( Gastrointest Endosc 2010;72:381-7.) Abbreviations: CE, capsule endoscopy. DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. (Research support for this study was provided by the Intelligent Microsystem Center, which carries out one of the 21st Century Frontier R&D Projects sponsored by the Ministry of Knowledge Economy of Korea.) *The first two authors contributed equally to this work. Copyright © 2010 by the American Society for Gastrointestinal Endoscopy 0016-5107/$36.00 doi:10.1016/j.gie.2009.12.058 Received October 13, 2009; Accepted December 17, 2009. Current affiliations: Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology (H.M.K., S.P., J.H.C., J.Y.P., S.Y.S., S.B.), Brain Korea 21 Project for Medical Science (S.Y.S.), Yonsei University College of Medicine; Nano-Bio Center (S.Y., J.K., E.Y.), Intelligent Microsystem Center (T.S.K.), Korea Institute of Science and Technology, Seoul, Korea. Reprint requests: Seungmin Bang, MD, Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea; and Eui-Sung Yoon, PhD, Nano-Bio Research Center, Korea Institute of Science and Technology, Hawolgok-dong, Seongbuk-gu, Seoul, 136-791, Republic of Korea. If you want to chat with an author of this article, you may contact Dr Bang at bang7028@yuhs.ac. www.giejournal.org Volume 72, No. 2 : 2010 GASTROINTESTINAL ENDOSCOPY 381