Wireless capsule endoscopy

Iddan, Gavriel J.; Meron, Gavriel; Glukhovsky, Arkady; Swain, Paul

doi:10.1038/35013140

Cited by 2,672 publications

(1,407 citation statements)

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“…Most modern endoscopes use incoherent fibre-optic bundles or distal light emitting diodes (LEDs) to illuminate the tissue and mini ature cameras to capture live video. Alternatively, wireless capsule endoscopy 22 , which provides live imaging via an untethered ingested capsule transiting the gastrointestinal tract, has been available since the early 2000s. This approach is considerably less invasive than standard endoscopy, but offers poorer imaging resolution and is non-steerable.…”

Section: Biomarkers For Eedmentioning

confidence: 99%

“…Capsules are inherently less invasive than standard endoscopes as they move through the body via natural motion induced by peristalsis rather than being manually manoeuvred by the clinician. Thus, they are less likely to cause damage to the intestinal epithelium during use 22 . Importantly, endoscopic placement of the capsule can enable use of capsule endoscopy in children who are unable to swallow the device 36 , although this method would obviate the benefit of the non-endoscopic approach to some degree.…”

Section: Biomarkers For Eedmentioning

confidence: 99%

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The potential role of optical biopsy in the study and diagnosis of environmental enteric dysfunction

Thompson

Hughes

Anastasova

et al. 2017

Nat Rev Gastroenterol Hepatol

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| Environmental enteric dysfunction (EED) is a disease of the small intestine affecting children and adults in low and middle income countries. Arising as a consequence of repeated infections, gut inflammation results in impaired intestinal absorptive and barrier function, leading to poor nutrient uptake and ultimately to stunting and other developmental limitations. Progress towards new biomarkers and interventions for EED is hampered by the practical and ethical difficulties of cross-validation with the gold standard of biopsy and histology. Optical biopsy techniques -which can provide minimally invasive or noninvasive alternatives to biopsy -could offer other routes to validation and could potentially be used as point-of-care tests among the general population. This Consensus Statement identifies and reviews the most promising candidate optical biopsy technologies for applications in EED, critically assesses them against criteria identified for successful deployment in developing world settings, and proposes further lines of enquiry. Importantly, many of the techniques discussed could also be adapted to monitor the impaired intestinal barrier in other settings such as IBD, autoimmune enteropathies, coeliac disease, graft-versus-host disease, small intestinal transplantation or critical care. Members of the board and experts met to discuss the horizon scan in London, UK, in November 2015 and San Francisco, USA, in February 2016. Literature searches were performed using Web of Science, as well as through the advice of the advisory board and experts. The results of the horizon scan are presented in this Consensus Statement, which entails a review of EED, a discussion of technologies deemed relevant to EED (based on literature searches and the opinions of the advisory board and experts), and a series of recommendations for the future application of the rele vant technologies to the study and diagnosis of EED. In the Recommendations section, each technology has been assessed according to its suitability for application to EED and this assessment includes an evaluation of the cost, invasiveness and appropriateness for developing countries of each device and/or technique. This assessment was performed in a qualitative manner based on currently available information (for example, the present cost and size of the devices) and the opinions of the authors as to feasible future develop ment. Technique suitability for use in developing countries was determined in a qualitative manner after consideration of the need for advanced infrastructure and high levels of training for either system use or data analysis. Probable deployment time scales have also been assigned to each technique based on the current states of development and the degree of valid ation work that will be required before application to EED. These timescales have been tentatively defined as short-term (suitable for deployment immediately or within ~1 year), mediumterm (suit able for deployment within ~1-3 years) and long-term (suitable for deployme...

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Section: Biomarkers For Eedmentioning

confidence: 99%

Section: Biomarkers For Eedmentioning

confidence: 99%

The potential role of optical biopsy in the study and diagnosis of environmental enteric dysfunction

Thompson

Hughes

Anastasova

et al. 2017

Nat Rev Gastroenterol Hepatol

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“…After a long period of development [1], wireless capsule endoscopy (CE) was finally presented to the medical community in 2000 [2]. This new endoscope has significant diagnostic capabilities and opened a new chapter in small bowel examination [3].…”

Section: Background and Aimsmentioning

confidence: 99%

The Effect of Metoclopramide in Capsule Enteroscopy

et al. 2009

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Clinical utility of prokinetics in capsule endoscopy (CE) is not clearly established. The objective of this prospective, randomized, single-blind, controlled trial was to determine if metoclopramide is useful in CE by increasing the rate of complete enteroscopy. Ninety-five patients referred for CE were randomized to no metoclopramide (group B, n = 48) or 10 mg metoclopramide (group A, n = 47). Complete enteroscopy was possible in 38 patients of group A (80.9%) and 37 of group B (77.1%) (P = 0.422) with two cases of gastric retention in group B (4.2%; P = 0.253). Median gastric transit time was 26 min (1-211) in group A and 28 min (4-200) in group B (P = 0.511). Mean small bowel transit time, calculated after excluding 20 patients with incomplete enteroscopy, was similar in both groups (221.2 ± 89 min vs. 256 ± 82.2 min; P = 0.083). There were also no differences in the total number of findings (group A 4.5 ± 4.7; group B 4.7 ± 3.7, P = 0,815). Administration of 10 mg metoclopramide orally 15 min before capsule ingestion did not significantly increase the rate of total enteroscopies and had no effect on transit times. It also did not modify CE diagnostic yield.

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“…VCE was primarily developed for examination of small bowel mucosa (14,15). Rapid technical refinement has since resulted in a dedicated capsule for the oesophagus, and recently capsules for the study of both stomach and colon (16).…”

Section: The Video Capsulementioning

confidence: 99%

Capsule enteroscopy and radiology of the small intestine

Fork

Aabakken

2007

Eur Radiol

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Capsule Enteroscopy and Radiology of the Small Intestine 2 ABSTRACT In a very few years, the video capsule for small bowel enteroscopy has gained widespread clinical acceptance. It is readily ingested, disposable, and allows for a complete, low-invasive endoscopic examination of the entire mucosa of the small bowel. It is a patient-friendly method and a first line procedure in the difficult evaluation of obscure gastrointestinal bleeding. It has the highest proven figure of diagnostic sensitivity for detecting lesions of the mucosa, irrespective of aetiology. The limitations of capsule endoscopy include difficulty in localizing mucosal lesions anatomically and its restricted use in patients with dysphagia, strictures or motor dysfunction. Strictures, transmural and extra-mural lesions in patients with small bowel Crohn's disease are evaluated by MRI-enterography and CT-enterography.Capsule Enteroscopy and Radiology of the Small Intestine 3 Imaging of the small bowel was, until recently, the responsibility of the radiologist, who, in dedicated centres, offered the patient not just a small-bowel follow-through with single exposures over time, but a dedicated, real time, fluoroscopic examination of a well distended small bowel, displayed in double-contrast and documented on spot films (1). This enteroclysis technique, well accepted by gastroenterologists, significantly improved both the detection of mucosal disease and the mapping of involved bowel segments. However, the duration of the examination, discomfort related to nasojejunal intubation and infusion of large volumes of contrast and distension materials, be it methyl cellulose or air (2), reduced general acceptance and dissemination of this method (3). VCE has evolved to be the first line procedure in many hospitals (7-13), keeping small bowel radiology as method of choice for patients who cannot take the capsule (13). In order to understand the diagnostic algorithm of modern small bowel examination we will discuss the video capsule technique, its indications and contraindications, advantages and disadvantages, types of true and false lesions and comparative studies of VCE and radiological methods of investigation of the small intestine. The video capsuleVCE was primarily developed for examination of small bowel mucosa (14,15). Rapid technical refinement has since resulted in a dedicated capsule for the oesophagus, and recently capsules for the study of both stomach and colon (16).The capsule measures 11 by 27mm and includes a light source and a camera inside a clear, transparent dome, batteries and a radio-transmitter (Figure 1). Whilst ushered forward by peristalsis the capsule transmits images continuously at two frames per second for around eight hours, a total of more than 60.000 images. The image has a 140° field of view, a focus depth of 1-30 mm, and an 8:1 magnification (17). An array of eight external detectors, applied to the abdominal wall, receives the images for storage in a solid state data recorder. Capsule Enteroscopy and Radiology of the Smal...

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Wireless capsule endoscopy

Cited by 2,672 publications

References 4 publications

The potential role of optical biopsy in the study and diagnosis of environmental enteric dysfunction

The potential role of optical biopsy in the study and diagnosis of environmental enteric dysfunction

The Effect of Metoclopramide in Capsule Enteroscopy

Capsule enteroscopy and radiology of the small intestine

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