Clinical Application of Capsule Endoscope

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.