J Korean Med Assoc.  2003 Aug;46(8):743-752. 10.5124/jkma.2003.46.8.743.

Clinical Application of Capsule Endoscope

Affiliations
  • 1Department of Gastroenterology, Korea University College of Medicine, Anam Hospital, Korea. kumcge@chollian.net

Abstract

Wireless capsule endoscopy is currently the outstanding technical innovation in diagnostic gastrointestinal endoscopy. Especially for small bowel diseases this new technique offers several potential advantages over traditional diagnostic tools. The Given Diagnostic Imaging System (Given Imaging Ltd, Norcross, GA) consists of 3 components : the M2A capsule, an external receiving antenna with an attached portable hard drive, and a personal computer workstation for review and interpretation of images. The M2A capsule is a single-use device measuring 11x 26 mm and weighing 3.7 g. It is made of a biocompatible plastic and contains a complimentary metal oxide silicon chip camera, lens, light source, battery, and radio telemetry transmitter. Images are transmitted at 2 per second to an antenna array worn on the abdomen and stored on a Walkman-sized data recorder. The Given system was approved by the Food and Drug Administration in August 2001. The method has chiefly been used in patients with obscure gastrointestinal bleeding, and in some cases has allowed additional diagnoses to be made in comparison with push enteroscopy, with a positive influence on patient management. Contraindications to performance of capsule endoscopy include known or suspected GI obstruction, strictures or fistula, and presence of a cardiac pacemaker, defibrillator, or other implanted electromedical device. The M2A capsule is probably just the first in a long line of wireless endoscopic devices. There are already prototypes of self-propelled devices. Soon to come will real-time imaging, devices to image the proximal GI tract and colon, and devices that can take biopsies or provide therapy.

Keyword

Capsule endoscope; Small bowel disease

MeSH Terms

Abdomen
Biopsy
Capsule Endoscopes*
Capsule Endoscopy
Colon
Constriction, Pathologic
Defibrillators
Diagnosis
Diagnostic Imaging
Endoscopy, Gastrointestinal
Fistula
Gastrointestinal Tract
Hemorrhage
Humans
Microcomputers
Plastics
Telemetry
United States Food and Drug Administration
Plastics

Figure

  • Figure 1

  • Figure 2

  • Figure 3

  • Figure 4


Reference

1. Fleischer DE. Capsule endoscopy : the voyage is fantastic-will it change what we do? Gastrointest Endosc. 2002. 56:452–456.
2. Fritscher-Ravens A, Swain CP. The wireless capsule : new light in the darkness. Dig Dis. 2002. 20:127–133.
3. Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endscopy. Nature. 2000. 405:417.
4. Appleyard M, Mosse C, Mills T, Swain P. Electrostimulation to move endoscopes in the small bowel. Endoscopy. 2000. 32:E59.
5. Appleyard MN, Gong F, Mills T, Mosse CA, Swain CP. Endoscopy without air insufflation. Gastrointest Endosc. 2000. 51:A260.
6. Lewis BS. The history of enteroscopy. Gastrointest Endosc Clin N Am. 1999. 9:1–11.
Article
7. Meron GD. The development of the swallowable video capsule (M2A). Gastrointest Endosc. 2000. 52:817–819.
Article
8. Mosse CA, Swain CP. Technical advanced and experimental devices for enteroscopy. Gastrointest Endosc Clin N Am. 1999. 9:145–161.
9. Scapa E, Meron G, Glukhovsky A, Gat D, Jacob H, Shreiber R. Wireless capsule colonoscopy. Gastrointest Endosc. 2001. 53:A111.
10. Seidman EG. Wireless capsule video-endoscopy : an odyssey beyond the end of the scope. J Pediatr Gastroenterol Nutr. 2002. 34:333–334.
11. Gong F, Swain P, Mills T. Wireless endoscopy. Gastrointest Endosc. 2000. 51:725–729.
Article
12. Swain CP, Gong F, Mills TN. Wireless transmission of a color television moving image from the stomach using a miniature CCD camera, light source and microwave transmitter. Gut. 1996. 39:A26.
13. Swain P. Wireless capsule endoscopy. Gut. 2003. 52:IV48–IV50.
Article
14. Appleyard Glukhovsky A, Jacob H. Transit times for the capsule endoscope. Gastrointest Endosc. 2001. 53:A122.
15. Fischer D, Shreiber R, Meron G, Frisch M, Jacob H, Engel A, et al. Localization of the wireless capsule endoscopy in its passage through the GI tract. Gastrointest Endosc. 2001. 53:A126.
16. Seitz U, Bohnacker S, Soehendra N. A simple method to determine the location of the capsule and thus whether prokinetic drugs are needed during video capsule endoscopy. Endoscopy. 2002. 34:1027.
Article
17. Stiffler HL. Capsule endoscopy : a case study of an 11-year-old girl. Gastroenterol Nurs. 2003. 26:38–40.
18. Appleyard M, Blukhovsky A, Swain P. Wireless capusle endoscopy for recurrent small-bowel bleeding. N Engl J Med. 2001. 344:232–233.
Article
19. Appleyard M, Fireman Z, Glukhovsky A, Jacob H, Shreiver R, Zaretsk A, et al. A randomized trial comparing wireless capsule endoscopy with push enteroscopy for the detection of small-bowel lesions. Gastroenterology. 2000. 119:1431–1438.
Article
20. Costamagna G, Shah SK, Riccioni ME, Foschia F, Mutignani M, Marano P, et al. A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease. Gastroenterology. 2002. 123:999–1005.
Article
21. Ell C, Remke S, May A, Helou L, Henrich R, Mayer G. The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding. Endoscopy. 2002. 34:685–689.
Article
22. Eliakim R, Fischer D, Suissa A, Yassin K, Katz D, Migdal M, et al. Wireless capsule video endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn's disease. Eur J Gastroenterol Hepatol. 2003. 15:363–367.
Article
23. Lewis B, Goldforb N. The advent of capsule endoscopy-a not-so-futuristic approach to obscure gastrointestinal bleeding. Aliment Pharmacol Ther. 2003. 1:1085–1096.
24. Lewis BS, Swain P. Capsule endoscopy in the evaluation of patients with suspected small intestinal bleeding : Results of a pilot study. Gastrointest Endosc. 2002. 56:349–353.
Article
25. Scapa E, Jacob H, Lewkowicz S, Migdal M, Gat D, Fireman Z, et al. Initial experience of wireless-capsule endoscopy for evaluating occult gastrointestinal bleeding and suspected small bowel pathology. Am J Gastroenterol. 2002. 97:2776–2779.
Article
26. Van Gossum A. Capsule endoscopy in patients with obscure GI bleeding. Gastrointest Endosc. 2003. 57:629.
27. Waye JD. Small-bowel endoscopy. Endoscopy. 2003. 35:15. 21.
Article
28. Zuckerman GR, Prakash C, Askin MP, Lewis BS. AGA technical review on the evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology. 2000. 118:201–221.
Article
29. Faigel DO, Fennerty MB. Cutting the cord for capsule endoscopy. Gastroenterology. 2002. 123:1385–1388.
Article
30. Fireman Z, Mahajna E, Broide E, Shapiro M, Fich L, Scapa E, et al. Diagnosing small bowel Crohn's disease with wireless capsule endoscopy. Gut. 2003. 52:390–392.
Article
31. Ginsberg GG, Barkun AN, Bosco JJ, Isenberg GA, Nguyen CC, Taitelbaum G, et al. Wireless capsule endoscopy : August 2002. Gastrointest Endosc. 2002. 56:621–624.
32. Gonzalez-Suarez B, Guarner C, Escudero JR, Viver E, Palmer J, Balanzo J. Wireless capsule video endoscopy : a new diagnostic method for aortoduodenal fissure. Endoscopy. 2002. 34:938.
Article
33. Mascarenhas-Saraiva M, Lopes L, Mascarenhas-Saraiva A. Watermelon stomach seen by wireless-capsule endoscopy. Endoscopy. 2003. 35:100.
Article
34. Mylonaki M, MacLean D, Fritscher-Ravens A, Swain P. Wireless capsule endoscopic detection of Meckel's diverticulum after nondiagnostic surgery. Endoscopy. 2002. 34:1018–1020.
Article
35. Nageshwar Reddy D, Sriram PV, Rao GV, Bhaskar Reddy D. Capsule endoscopy appearances of small-bowel tuberculosis. Endoscopy. 2003. 35:99.
Article
36. Sultan S, Dobozi BM, Palmer P, Treem WR, Agrawal NM. Assisted wireless capsule endoscopy in a six-year-old with abdominal pain and obscure GI bleeding. DDW. 2003. M1725.
37. Lewkowicz S, Shreiber R, Jacob H, Gat D, Kraizer Y, Seligson B. Results of the 1st study of the safety, transit time and dynamics of the M2A patency capsule in healthy volunteers. DDW. 2003. 491.
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr