Capsule endoscopy

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In gastroenterology, capsule endoscopy is a gastrointestinal endoscopy that "non-invasive, endoscopic imaging by use of video capsule endoscopes to perform examination of the gastrointestinal tract, especially the small bowel."[1]

Technology

The core technology is a video camera and lights that transmit to antennas wrapped around the body. Beyond this, however, newer capsules contain accelerometers and gyroscopes that can time and track its passage through the body. [2] Later devices are controllable as to position with an external magnetic field, so the examiner can give a detailed look to an area of interest. This control mechanism draws from robotic navigation systems used in invasive cardiology.

Position information can be acquired by a number of methods, although the more precise ones present a hazard of ionizing radiation.

  1. two-dimensional triangulation of the radio signal from the capsule and possibly inertial navigation
  2. fine two- and three-dimensional positioning aided fluoroscopic imaging.[3]

Clinical benefits

It can examine parts of the small intestine not reachable by other internal viewing methods.

The benefit of capsule endoscopy in the evaluation of gastrointestinal hemorrhage is uncertain according to a randomized comparison to diagnostic imaging.[4]

Potentially, the ability of the capsule to track its speed and direction, when not under external control, can provide information on gastrointestinal mobility at a level not available from other modalities.

Risks

It is possible that a partial occlusion of the gastrointestinal tract could entrap the capsule. This is not a risk with virtual colonoscopy, and, with traditional colonoscopy, the examiner could recover immediately.

References

  1. Anonymous (2015), Capsule endoscopy (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Colin S. McCaffery, Olivier Chevalerias, Cian O’Mathuna, and Karen Twomey (2008), "Swallowable-Capsule Technology", Pervasive Computing
  3. Federico Carpi (2010), "Magnetic capsule endoscopy: the future is around the corner", Expert Rev. Med. Devices 7 (2): 161–164
  4. Laine L, Sahota A, Shah A (2010). "Does capsule endoscopy improve outcomes in obscure gastrointestinal bleeding? Randomized trial versus dedicated small bowel radiography.". Gastroenterology 138 (5): 1673-1680.e1; quiz e11-2. DOI:10.1053/j.gastro.2010.01.047. PMID 20138043. Research Blogging.