Video capsule endoscopy: Perspectives of a revolutionary technique

Abstract

Video capsule endoscopy (VCE) was launched in 2000 and has revolutionized direct endoscopic imaging of the gut. VCE is now a first-line procedure for exploring the small bowel in cases of obscure digestive bleeding and is also indicated in some patients with Crohn's disease, celiac disease, and polyposis syndrome. A video capsule has also been designed for visualizing the esophagus in order to detect Barrett's esophagus or esophageal varices. Different capsules are now available and differ with regard to dimensions, image acquisition rate, battery life, field of view, and possible optical enhancements. More recently, the use of VCE has been extended to exploring the colon. Within the last 5 years, tremendous developments have been made toward increasing the capabilities of the colon capsule. Although colon capsule cannot be proposed as a first-line colorectal cancer screening procedure, colon capsule may be used in patients with incomplete colonoscopy or in patients who are unwilling to undergo colonoscopy. In the near future, new technological developments will improve the diagnostic yield of VCE and broaden its therapeutic capabilities.

Current technologies for the endoscopic assessment of duodenal villous pattern in celiac disease

“…Videocapsule endoscopy is a new technology recently introduced (2000 s), which represents a breakthrough in the diagnosis and management of gastrointestinal diseases, especially of small bowel ones [71]. It consists of a camera placed on a capsule that passes through the gastrointestinal tract.…”

Novel insights into esophageal diagnostic procedures

“…Recent advances have focused on application to the esophagus, with mixed results, as it is limited by rapid esophageal transit and the inability to take biopsies . Some mechanical limitations have been overcome by applying magnetic steering or the use of string tethers . However, its use is still limited compared with standard endoscopy, which allows chromoendoscopy and biopsy.…”

“…18 Some mechanical limitations have been overcome by applying magnetic steering or the use of string tethers. [19][20][21] However, its use is still limited compared with standard endoscopy, which allows chromoendoscopy and biopsy. Chromoendoscopy using methylene blue is no longer recommended owing to risks associated with that agent.…”

Alternatives to colonoscopy for population-wide colorectal cancer screening

“…It is also not recommended in pregnancy or with implanted electromedical devices such as pacemakers. 62 The cost of CCE is much higher than that of colonoscopy, 65 and includes the reading of the captured video footage. There is also no current evidence to prove the mortality benefit of CCE use in CRC.…”

“…Some newer capsules also have four cameras to provide a 360-degree view. 62 Despite its promising role in screening, some disadvantages of CCE have limited its use thus far. Strict bowel preparation, diet restrictions, and use of suppositories and prokinetics may be needed to ensure a smooth and quick journey of the capsule through the bowel, while minimising the interference of debris when identifying lesions.…”