208:. Standard endoscopy can be more uncomfortable for a patient, can be more prone to puncturing the digestive tract walls, and is not able to access the middle portion of the small intestine. Endoscopes must enter either through the mouth/nasal cavities or the rectum. Due to restrictions in length, extremely important regions for diagnosis in the small intestine are not able to be accessed. Currently, within the United States, capsule endoscopy can not be used as a primary imaging method over standard endoscopy first. As a result, many patients must first undergo standard endoscopy to then be referred for capsule endoscopy. Further innovation will be required to make capsule endoscopy comparable to the current standard of care, but extensive work is being performed to achieve this.
288:
requires the capsule, sensor array, storage unit, and computer system being used. First, a patient will need to have the sensor array placed on their abdomen with a recording unit worn as a belt. The patient may be asked to stay at the hospital or return home depending on the start time. Next, the pill must be swallowed by the patient. After approximately 8 hours the sensor array can be removed and returned to a physician. The capsule will be excreted through regular bowel movements.
201:. Depending on the placement of the camera system within the device images may become obstructed by folds in the digestive tract. Due to the passive nature of image capture and lack of control in maneuvering the device through the digestive tract novel solutions are being developed by various companies and research labs. For systems that utilize the setup with the camera system at the end of the capsule, the field of view ranges from 140 to 170 degrees.
82:
40:
98:
90:
136:, ulcers, unexplained bleedings, and general abdominal pains. After a patient swallows the capsule, it passes along the gastrointestinal tract, taking a number of images per second which are transmitted wirelessly to an array of receivers connected to a portable recording device carried by the patient. General advantages of capsule endoscopy over standard
156:) camera-based imaging system using a fiber-optic tether. This initial design suffered from high power consumption and slow transmission times of image data of at best 10 minutes. In 1993 Iddan had the idea to split the system into three components, the camera and transmitter, the recorder attached to a
263:. However, unlike EGD or colonoscopy, it cannot be used to treat pathology that may be discovered. Common reasons for using capsule endoscopy include diagnosis of unexplained bleeding, iron deficiency, or abdominal pain, searching for polyps, ulcers, and tumors of the small intestine, and diagnosis of
189:
Capsule endoscopy uses a small vitamin-sized wireless camera to capture images of a patient's digestive tract. The capsule is generally composed of a camera, antenna, and light array. Due to the small nature of the device images can not be stored within it. As a result, a sensor array with a storage
337:
a common cause; most were surgically removed. The rate of capsule retention varies by the indication for the procedure, with the highest rate seen with known Crohn's disease (5-13%), followed by obscure gastrointestinal bleeding (1.5%), suspected Crohn's disease (1.4%), and healthy volunteers (0%).
287:
Capsule endoscopy requires a number of different preparatory procedures to ensure clear images are taken of a patient's gastrointestinal tract for an accurate diagnosis of disease. There are various types of capsule endoscopes, but for a generalized description, one can assume the most common setup
193:
Newer models of the capsule endoscope have looked to add camera systems on both ends of the pill or even store images within the pill itself to minimize the amount of medical equipment carried while using the device. For systems that store images directly within the pill, the pill must be collected
271:
radio-frequency signal emitted by some capsules can be used to accurately estimate the location of the capsule and to track it in real-time inside the body and gastrointestinal tract. Capsule endoscopy can still not yet replace standard endoscopy for various diseases, as is the case for those with
324:
within 24–48 hours after ingestion. There has been a single report of retention of the capsule lasting almost four and a half years although the patient was asymptomatic. However, the risk of bowel obstruction may be countered by an abdominal X-ray to locate the device for removal by endoscopy or
278:
As of 2014, research was targeting additional sensing mechanisms and localization and motion control systems to enable new applications for the technology, for example, drug delivery. Wireless energy transmission was also being investigated as a way of providing a continuous energy source for the
270:
The images collected by the miniature camera during a session are transferred wirelessly to an external receiver worn by the patient, using any one of a band of appropriate frequencies. The collected images are then transferred to a computer for display, review, and diagnosis. A transmitted
291:
During the procedure, there are a number of different policies to follow. A patient should only drink clear liquids for the first two hours after swallowing the pill and may eat after 4 hours. MRI studies, ham radios, metal detectors, and strenuous physical activity should all be avoided.
176:
for use in patients. Many new models such as the PillCam SB and DBE for obscure gastrointestinal bleeding, the
Olympus CE for the small bowel, the PillCam ESO for investigation of esophageal diseases, and the PillCam COLON for detection of colonic neoplasias have been created.
165:) camera. These cameras consume just one percent of the energy of their CCD counterparts. The more efficient power system allowed for the removal of the fiber optic cable for a stand-alone imaging system. This three-component imaging system remains popular today.
180:
As research into capsule endoscopy has increased and technology has advanced better wireless and more energy-efficient systems have allowed for the creation of more compact capsules and image processing systems, with many in development today.
254:
Capsule endoscopy is therefore used to examine parts of the gastrointestinal tract that cannot be seen by standard endoscopy. It is useful when the disease is suspected in the small intestine, and can sometimes be used to find the site of
160:
on the patient's abdomen, and a software package that processes the stored data at leisure by a physician at a later time. This new setup was made possible by the replacement of the CCD camera with a CMOS
881:
Rokkas T, Papaxoinis K, Triantafyllou K, Pistiolas D, Ladas SD (January 2009). "Does purgative preparation influence the diagnostic yield of small bowel video capsule endoscopy?: A meta-analysis".
312:
today (2024) produces one of the more widely used capsule endoscope systems called the PillCam having sold over 4 million units. Medtronic purchased the PillCam system from Given
Imaging in 2014.
190:
unit is placed on the abdomen of the patient for the imaging period. This storage unit can then be connected to a computer at a later time so that a medical professional can analyze the images.
1153:
Liao Z, Gao R, Xu C, Li ZS (February 2010). "Indications and detection, completion, and retention rates of small-bowel capsule endoscopy: a systematic review".
320:
Capsule endoscopy is considered to be a very safe method for gastrointestinal tract examination. The capsule is usually excreted with a patient's
300:
As of 2022, there are a number of manufacturers who produce capsule endoscopes. The technology was originally developed by
Israeli scientists,
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include the minimally invasive procedure setup, ability to visualize more of the gastrointestinal tract, and lower cost of the procedure.
865:
488:
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515:
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362:
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and
Israeli gastroenterologist Eitan Scapa in Boston, Massachusetts in the early 1980s. The two partners first developed a CCD (
666:"Diagnostic yield of capsule endoscopy in the setting of iron deficiency anemia without evidence of gastrointestinal bleeding"
219:(EGD), employs a camera attached to a long flexible tube to view the upper portion of the gastrointestinal tract, namely the
801:"Capsule endoscopy for the diagnosis of oesophageal varices in people with chronic liver disease or portal vein thrombosis"
1078:
169:
1250:
540:
264:
251:. These two types of endoscopy however cannot visualize the majority of the middle portion of the small intestine.
216:
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133:
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and release medication at specific locations of the entire gastrointestinal tract. Unlike the more widely used
50:
1054:
129:
109:
153:
1191:
Cave D, Legnani P, de
Franchis R, Lewis BS (October 2005). "ICCE consensus for capsule retention".
750:
Pourhomayoun M, Fowler M, Jin Z (2012). "A novel method for medical implant in-body localization".
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Risk factors for capsule retention include Crohn's disease, NSAID use, and abdominal radiation.
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2012 Annual
International Conference of the IEEE Engineering in Medicine and Biology Society
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615:"Overview of technical solutions and assessment of clinical usefulness of capsule endoscopy"
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Colli A, Gana JC, Turner D, Yap J, Adams-Webber T, Ling SC, Casazza G (October 2014).
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1104:"Longest duration of retention of video capsule: A case report and literature review"
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There are several advantages to choosing to use capsule endoscopy over standard
39:
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969:
759:
631:
458:
1022:
857:
728:
445:
Nakamura T, Terano A (2008). "Capsule endoscopy: past, present, and future".
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In a review of 22,840 cases, the capsule was retained 1.4% of the time, with
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124:, capsule endoscopy provides the ability to see the middle portion of the
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232:
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894:
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and Eitan Scapa, with the first pill swallowed in 1997; Iddan founded
715:
Yuce MR, Dissanayake T (2012). "Easy-to-swallow wireless telemetry".
240:
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after excretion for extraction of the images by a secondary device.
1007:"PillCam COLON capsule endoscopy: recent advances and new insights"
321:
248:
96:
88:
80:
361:. Max Planck Institute for Intelligent Systems. January 7, 2016.
162:
564:
Wang Q, Khanicheh A, Leiner D, Shafer D, Zobel J (March 2017).
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Capsule endoscopy was first conceptualized by
Israeli engineer
664:
Tong J, Svarta S, Ou G, Kwok R, Law J, Enns R (October 2012).
108:
is a medical procedure used to record internal images of the
850:
Wiley
Encyclopedia of Electrical and Electronics Engineering
384:
247:
and the distal portion of the small intestine, the terminal
85:
Endoscopic capsule end-on, showing six LEDs and camera lens.
953:"Capsule endoscopy of the future: What's on the horizon?"
848:
Yuce MR, Alici G, Than TD (2014). "Wireless
Endoscopy".
292:
Additionally, all external equipment must be kept dry.
951:
Slawinski PR, Obstein KL, Valdastri P (October 2015).
93:
Image of the intestines acquired by capsule endoscopy
259:
or the cause of unexplained abdominal pain, such as
172:) approved the first capsule endoscope developed by
63:
49:
32:
1079:"Covidien Completes Acquisition of Given Imaging"
197:The main shortcoming of capsule endoscopy is the
128:. It can be applied to the detection of various
101:Image of the colon acquired by capsule endoscopy
308:in Israel which received FDA approval in 2001.
1055:"Capsule Endoscopy Products | Medtronic (UK)"
227:, and the beginning of the first part of the
8:
541:"The Comprehensive Capsule Endoscopy System"
1108:World Journal of Gastrointestinal Endoscopy
1102:Bhattarai M, Bansal P, Khan Y (July 2013).
805:The Cochrane Database of Systematic Reviews
396:"The history of time for capsule endoscopy"
116:. Newer developments are also able to take
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978:
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1011:Therapeutic Advances in Gastroenterology
883:The American Journal of Gastroenterology
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1184:
928:"Capsule Endoscopy | Michigan Medicine"
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163:complementary metal–oxide–semiconductor
754:. Vol. 2012. pp. 5757–5760.
29:
1000:
998:
922:
920:
566:"Endoscope field of view measurement"
516:"PillCam™ Crohn's System | Medtronic"
380:"The endoscopy procedures we provide"
7:
670:Canadian Journal of Gastroenterology
510:
508:
1005:Adler SN, Metzger YC (July 2011).
25:
957:World Journal of Gastroenterology
489:"Capsule endoscopy - Mayo Clinic"
356:"Diagnostics with a Stomach Pill"
400:Annals of Translational Medicine
368:from the original on 2017-03-21.
817:10.1002/14651858.CD008760.pub2
1:
619:BioMedical Engineering OnLine
613:Koprowski R (December 2015).
170:Food and Drug Administration
1246:Diagnostic gastroenterology
447:Journal of Gastroenterology
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1155:Gastrointestinal Endoscopy
265:inflammatory bowel disease
217:Esophagogastroduodenoscopy
33:Wireless Capsule Endoscopy
18:Wireless capsule endoscopy
1167:10.1016/j.gie.2009.09.031
970:10.3748/wjg.v21.i37.10528
760:10.1109/EMBC.2012.6347302
632:10.1186/s12938-015-0108-3
570:Biomedical Optics Express
459:10.1007/s00535-007-2153-6
257:gastrointestinal bleeding
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27:Medical imaging procedure
1023:10.1177/1756283X11401645
858:10.1002/047134608X.W8233
729:10.1109/MMM.2012.2205833
130:gastrointestinal cancers
1256:21st-century inventions
717:IEEE Microwave Magazine
413:10.21037/atm.2017.03.90
239:, inserted through the
1121:10.4253/wjge.v5.i7.352
154:charged coupled device
110:gastrointestinal tract
102:
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1205:10.1055/s-2005-870264
394:Adler SN (May 2017).
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582:10.1364/BOE.8.001441
44:Picture of a capsule
963:(37): 10528–10541.
895:10.1038/ajg.2008.63
683:10.1155/2012/182542
382:. 28 November 2018.
1251:Israeli inventions
932:www.uofmhealth.org
493:www.mayoclinic.org
134:digestive diseases
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1199:(10): 1065–1067.
1059:www.medtronic.com
852:. pp. 1–25.
769:978-1-4577-1787-1
520:www.medtronic.com
329:Risk of retention
168:In 2001 the FDA (
114:disease diagnosis
106:Capsule endoscopy
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453:(2): 93–99.
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158:sensor array
147:
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65:OPS-301 code
237:colonoscope
231:called the
112:for use in
1235:Categories
1088:2022-04-11
1064:2022-04-11
937:2022-04-11
625:(1): 111.
550:2022-04-11
525:2022-04-11
498:2022-04-11
406:(9): 194.
342:References
185:Technology
1241:Endoscopy
1221:260129396
1193:Endoscopy
325:surgery.
310:Medtronic
283:Procedure
279:capsule.
273:cirrhosis
221:esophagus
206:endoscopy
138:endoscopy
122:endoscope
1213:16189792
1175:20152309
1140:23858380
1041:21765870
989:26457013
911:25237140
903:19098872
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778:23367237
737:31486989
702:23061059
651:26626725
600:28663840
475:25358336
467:18306982
432:28567374
363:Archived
233:duodenum
118:biopsies
1131:3711067
1032:3131168
980:4588075
826:7173747
786:1784308
693:3472906
642:4665909
591:5480555
423:5438796
225:stomach
144:History
57:D053704
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241:rectum
223:, the
1217:S2CID
907:S2CID
782:S2CID
733:S2CID
471:S2CID
366:(PDF)
359:(PDF)
322:feces
249:ileum
245:colon
74:1-656
70:1-63a
1209:PMID
1171:PMID
1136:PMID
1037:PMID
985:PMID
899:PMID
862:ISBN
831:PMID
809:2014
774:PMID
764:ISBN
698:PMID
647:PMID
596:PMID
463:PMID
428:PMID
235:. A
51:MeSH
1201:doi
1163:doi
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