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At least 19 recordsLinked to original sources

Endoscopic capsule endoscope delivery for patients with dysphagia, anatomical abnormalities, or gastroparesis.

BACKGROUND: Capsule endoscopy relies on an intact swallowing mechanism and unimpeded passage of the capsule through the pylorus. A technique is described for endoscopic delivery of the capsule in patients with dysphagia, anatomical abnormality, or gastroparesis. METHODS: EGD is performed with concomitant placement of an overtube. A foreign body net retrieval device is passed through the endoscope and used to grasp the activated capsule in the net. The endoscope then is advanced through the overtube, and the capsule is released in the duodenum. OBSERVATIONS: Five patients underwent endoscopic placement of the capsule. Relative contraindications to peroral ingestion were the following: oropharyngeal dysphagia, pyloric stenosis (2), prior gastric surgery, and gastroparesis. Endoscopic delivery was successful in all cases and yielded positive findings in 4. There was no complication. CONCLUSIONS: Endoscopic delivery of the capsule endoscope for patients with dysphagia, anatomical abnormality, or gastroparesis is safe and effective.

Adult↗

Endoscopic placement of the capsule endoscope in children.

BACKGROUND: Capsule endoscopy provides a minimally invasive examination of the entire small bowel. However, some children and disabled adults may be unable to independently ingest the capsule. A new method for endoscopic placement of the capsule endoscope is described. METHODS: Consecutive children who required capsule endoscopy of the small bowel and who were unable to independently ingest the capsule were selected for endoscopic placement. A net retrieval catheter and a translucent ligation adaptor were used to hold and stabilize alignment of the capsule during endoscopic insertion into the distal duodenum. RESULTS: Eleven pediatric patients underwent successful endoscopic placement of a capsule endoscope in the duodenum without complication. One capsule migrated back into the stomach, where it remained for the life of the battery. CONCLUSIONS: Endoscopic placement of the capsule endoscope by using the described technique appears to be effective and safe. It facilitates capsule endoscopy in patients who are unable to independently ingest the capsule.

Adolescent↗

Endoscopic retrieval of a capsule endoscope from a Zenker's diverticulum.

We report a case of a capsule endoscope lodged within a Zenker's diverticulum. The capsule was safely removed endoscopically. Safe re-insertion of the capsule was achieved using an overtube placed with a Savary dilator. While capsule endoscopy should be avoided in patients with large esophageal diverticula or dysphagia, this method may be used to deliver the capsule beyond the esophagus, allowing completion of the capsule endoscopy study.

Aged↗

[Capsule endoscopic diagnosis and treatment with intraoperative endoscopic assistance of vascular malformation of small intestine with bleeding].

OBJECTIVE: To evaluate the effect of capsule endoscopic examination in the diagnosis of vascular malformation of small intestine and discuss the operative method of this disease. METHODS: The clinical data of 11 cases of vascular malformation of small intestine by the capsule endoscopic diagnosis were analyzed retrospectively. RESULTS: All of the 11 cases received operation with the assistance of intra-operative endoscopic examination, and 10 cases were confirmed to suffer from vascular malformation of small intestine postoperatively. The methods of operation included dot-resection, wedge-shaped resection and segmental resection. CONCLUSIONS: The capsule endoscopic examination is optimal for the diagnosis of vascular malformation of small intestine. Dot-resection, wedge-shaped resection and segmental resection with the assistance of intra-operative endoscopic examination for the surgical intervention of this disease are recommendable.

Adult↗

Magnetic shells for gastrointestinal endoscopic capsules as a means to control their motion.

Wireless endoscopic video capsules are becoming largely used today for non-invasive explorations of the digestive tube. Traditional types of such capsules present a major drawback: their motion can not be controlled, since they proceed by means of the visceral peristalsis only. In order to enable a wireless control of their motion, this paper describes a new concept based on the use of external magnetic fields. The proposed technique exploits magnetic shells to be applied to traditional capsules prior to their use. The shells are capable of interacting with an imposed external magnetic field, providing a means to control the capsule movement and orientation. This solution is readily and cheaply applicable to any commercial endoscopic capsule, avoiding internal modifications. The paper reports results of preliminary bench tests. Prototype elastic shells made of a silicone elastomer mixed with magnetic particles were fabricated and tested with the Given Imaging M2A capsule in simplified experimental conditions. These tests permitted to demonstrate translations, rotations and roto-translations of the capsule/shell complex onto pieces of bovine tissues.

Capsule Endoscopes↗

An ultra-low-power image compressor for capsule endoscope.

BACKGROUND: Gastrointestinal (GI) endoscopy has been popularly applied for the diagnosis of diseases of the alimentary canal including Crohn's Disease, Celiac disease and other malabsorption disorders, benign and malignant tumors of the small intestine, vascular disorders and medication related small bowel injury. The wireless capsule endoscope has been successfully utilized to diagnose diseases of the small intestine and alleviate the discomfort and pain of patients. However, the resolution of demosaicked image is still low, and some interesting spots may be unintentionally omitted. Especially, the images will be severely distorted when physicians zoom images in for detailed diagnosis. Increasing resolution may cause significant power consumption in RF transmitter; hence, image compression is necessary for saving the power dissipation of RF transmitter. To overcome this drawback, we have been developing a new capsule endoscope, called GICam. METHODS: We developed an ultra-low-power image compression processor for capsule endoscope or swallowable imaging capsules. In applications of capsule endoscopy, it is imperative to consider battery life/performance trade-offs. Applying state-of-the-art video compression techniques may significantly reduce the image bit rate by their high compression ratio, but they all require intensive computation and consume much battery power. There are many fast compression algorithms for reducing computation load; however, they may result in distortion of the original image, which is not good for use in the medical care. Thus, this paper will first simplify traditional video compression algorithms and propose a scalable compression architecture. CONCLUSION: As the result, the developed video compressor only costs 31 K gates at 2 frames per second, consumes 14.92 mW, and reduces the video size by 75% at least.

Algorithms↗

[Intestinal perforation secondary to impaction of a retained endoscopic capsule].

We present the first documented case of intestinal perforation due to impaction of an endoscopic capsule. The capsule was used to investigate anemia in an 80-year-old woman and was retained in the intestinal lumen for 2 months without producing symptoms. The patient presented to the emergency service with sudden, intense, diffuse abdominal pain. Hollow viscus perforation was suspected and surgery was performed. The diagnosis was distal ileum perforation secondary to an impacted endoscopic capsule in an area of severe postsurgical adhesions under a subcostal cholecystectomy incision performed 10 years previously. After reviewing the literature, we believe it important to report this exceptional complication of capsule endoscopy and suggest the possible management of capsules retained in the digestive tract.

Aged, 80 and over↗

[Role of endoscopic capsule in the diagnosis of digestive diseases].

The recent development of the endoscopic capsule allows for the endoscopic study of the whole small intestine on a safe and non-invasive basis. Digestive hemorrhage of unknown origin is the main indication of the technique (sensitivity 89%, specificity 95%). In these cases, a high diagnostic accuracy is seen in patients with active bleeding (92.3%), which nevertheless decreases notably in patients with previous non-active bleeding (12.9%). Capsule endoscopy has also been proposed in patients with a clinical and laboratory suspicion of Crohn's disease involving the small bowel which has not been diagnosed through conventional techniques. Finally, the usefulness of capsule endoscopy for the management of other diseases such as celiac disease, intestinal tumors, gastrointestinal polyposis, abdominal pain of unknown origin, in pediatric patients or in the bowel involvement of systemic diseases should be established by means of well-designed, broad studies.

Capsules↗

The risk of retention of the capsule endoscope in patients with known or suspected Crohn's disease.

OBJECTIVES: Capsule endoscopy (CE) allows visualization of the mucosa of the entire small bowel and is therefore a potentially important tool in the evaluation of patients with known or suspected Crohn's disease (CD). However, small bowel strictures, which are not uncommon in Crohn's, are considered to be a contraindication to CE for fear of capsule retention. Our goal was to determine the risk of capsule retention in patients with suspected or known CD. METHODS: We retrospectively reviewed the records of 983 CE cases performed at three private gastroenterology practices between December 2000 and December 2003, and selected those with suspected or proven Crohn's. RESULTS: A total of 102 cases were identified in which CE was used in patients with suspected (N = 64) or known (N = 38) CD. Only one of 64 patients (1.6%) with suspected CD had a retained capsule. However, in five of 38 (13%) patients with known Crohn's, the capsule was retained proximal to a stricture. Of the five cases of retained capsules, three strictures were previously unknown. In four cases, the obstructing lesions were resected without complications, leading to complete resolution of the patient's underlying symptoms. One patient chose not to undergo surgery and has remained without an episode of small bowel obstruction for over 38 months. CONCLUSIONS: Capsule retention occurred in 13% (95% CI 5.6%-28%) of patients with known CD, but only in 1.6% (95% CI 0.2%-10%) with suspected Crohn's. A retained capsule may indicate unsuspected strictures in Crohn's that may require an unexpected, but therapeutic, surgical intervention. Patients and physicians should be aware of these potential risks when using CE in CD.

Adolescent↗

Capsule endoscope NORIKA system.

The NORIKA Project Team is the development group responsible for the battery-free micro capsule endoscope. RF SYSTEM lab's specialization is the integration of microwave and charge coupled device (CCD) camera technologies. The NORIKA system is powered wirelessly from outside the body, and totally eliminates the risks involved with toxic substances coming from batteries entering the human body. This system can work on continuous stable power supply and guarantee longer durational usage than is possible with batteries. Concerning image reproduction and brightness, the CCD sensor is a primary choice as an image-capturing device, but its power consumption is quite high. To circumvent this, the digital signal processor (DSP), which consumes most of the total power, is separated from the CCD sensor and is placed outside the human body. The camera's focusing feature and the intensity of independently controlled four LED lamps enables clear images to be monitored even in the darkness inside the body. Capsule rotation can also be accomplished for detailed examination. This rotation mechanism combines 3-pole motor theory with strobe light technology. The external unit to transmit data and power includes a coil-embedded vest and a joystick-type controller. The NORIKA system could be an optional diagnostic tool in the near future.

Journal Article↗

Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy.

BACKGROUND AND STUDY AIMS: This study was designed to prospectively compare the diagnostic yield of the M2A endoscopic capsule with that of video push-enteroscopy in exploring the small intestine in patients with obscure digestive bleeding. PATIENTS AND METHODS: Patients with either occult or overt obscure digestive bleeding and a negative endoscopic work-up underwent a double intestinal investigation, with video push-enteroscopy and a wireless capsule, performed blindly by separate examiners. The diagnostic yield for each technique was defined as the frequency of detection of clinically relevant intestinal lesions, i. e. those having the potential for bleeding. RESULTS: 60 patients (27 men, 33 women; age 58 +/- 18 years; hemoglobin 9.4 +/- 2.5 g/dl) were included, 32 with occult and 28 with overt bleeding. Results were analyzed for 58 patients, who completed both examinations. Lesions were detected in 43 patients: with both techniques in 19, only by capsule in 21, and, conversely, only by push-enteroscopy in 3 ( P = 0.04). Final diagnoses were as follows: a P2 lesion with high bleeding potential in 28 patients (19 angiomata, 6 ulcerations, 2 tumors, 1 case of intestinal varices); a P1 lesion with intermediate bleeding potential in 15 patients (2 patients with mucosal erosions, 13 patients with mucosal red spots); and there were normal findings from 15 procedures. No procedure induced any complication. CONCLUSION: The use of the wireless endoscopy capsule detects significantly more clinically relevant intestinal lesions than video push-enteroscopy in patients with obscure digestive bleeding, raising the diagnostic yield to 67.2 %. Its influence on the clinical outcome for patients needs further investigation.

Adult↗

[Effectiveness of endoscopic capsule for the detection of small-bowel bleeding of unknown origin and for the diagnosis of Crohn's disease].

The objective of this study is to assess the effectiveness of the endoscopic capsule for the diagnosis of bleeding of the small bowel and of Crohn's disease. A systematic review was performed. Studies with more than 10 patients, using the capsule and some other procedure for diagnostic purposes, and published in peer reviewed journals, were included. In order to evaluate the papers, a quality scale was created. The diagnostic yield of the capsule for small-bowel bleeding was approximately 55-75%. With other procedures, the diagnostic yield was around 30%. For Crohn's disease, the diagnostic yield of the capsule was between 43-70% while it was 0-50% with other procedures. The reviewed studies have methodological limitations, yet they seem to point to the fact that the capsule may have a better diagnostic yield than other diagnostic procedures for small-bowel bleeding and Crohn's disease.

Capsules↗

Wireless capsule endoscopic detection of Meckel's diverticulum after nondiagnostic surgery.

A patient aged 26 was investigated for recurrent severe gastrointestinal bleeding. Over a 4-year period, he was transfused more than 400 units of blood. Multiple investigations included three negative Meckel's scans. A right hemicolectomy for supposed angiodysplasia failed to control his bleeding. Wireless capsule endoscopy demonstrated the presence of a Meckel's diverticulum. At a repeat laparotomy, the ulcerated Meckel's diverticulum was identified and resected. The patient had no further bleeding and had a normal haemoglobin level on repeat blood tests up to 12 months after surgical excision of the diverticulum.

Adult↗

Endoscopic capsule biopsy of the small intestine.

In this article, we describe a technique for obtaining jejunal biopsies endoscopically using an infant Crosby or Watson capsule. The method is quick, safe, and may be particularly useful if radiological screening is unavailable.

Biopsy↗