Use of a Real‐time Viewer for Endoscopic Deployment of Capsule Endoscope in the Pediatric Population

Abstract

The use of the RT viewer for endoscopic deployment of WCE is an effective technique to improve visualization of capsule placement in the pediatric population.

Jejunal varices diagnosed by capsule endoscopy in patients with post‐liver transplant portal hypertension

“…Challenges include endoscopic placement in a patient with unusual anatomy as well as risk of retention in a patient with previous abdominal surgery . We have shown that use of the AdvanCE CE delivery device and a RT viewer during endoscopic placement of the capsule endoscope as was performed in all of these patients is useful for negotiating unusual anatomy such as seen after extensive abdominal surgery as in these patients . At our institution, the decision to perform CE is made in conjunction with medical and surgical teams so that, while every effort is made to avoid a situation which may result in a retained capsule, both the parents and the care teams are prepared to properly deal with capsule retention if it occurs.…”

“…The given wireless video CE system with SB2 capsules and the given RT imager (Covidien Ltd., Yokneam, Israel) were used to perform the CE in all patients. Endoscopic placement with the assistance of the RT viewer was performed as described . All procedures were performed under general endotracheal anesthesia with the patient in the left lateral decubitus position.…”

Body Position Adjustment May Facilitate Capsule Endoscopic Real-Time Examination in Patients with a Large Amount of Food Retention in the Stomach

“…Bass and Misiewicz1 used a real-time viewer to determine the delay in capsule transit, and used an endoscope to pass the capsule endoscope into the duodenum. However, in our case, the patient had significant food retention in the stomach, and thus this method would not be useful.…”

“…It causes minimal harm and is easily accepted by patients 1,2. However, bowel preparation can be limited and dangerous if the patients have active upper GI bleeding.…”

Small Bowel Capsule Endoscopy

“…Accordingly, the routine use of real-time viewing is recommended post-ingestion to confirm that the capsule is within the gastrointestinal tract [435,436]. Every study should include real-time viewing 30-45 min after ingestion to confirm that the capsule has reached the duodenum; however, for those patients deemed to be at risk of aspiration or who develop symptoms, real-time viewing should be done immediately after the capsule has been swallowed to confirm gastric entry.…”