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CAPSULE ENDOSCOPY

General Considerations

The first human ingestion of a video capsule endoscope occurred in 1999, and high-quality images from healthy human volunteers were described in 2000. In August 2001, the US Food and Drug Administration (FDA) approved a commercially available capsule for use in the United States. The capsule had been approved for use in Europe earlier that year.

Five video capsules are available for use in the United States. Three of the capsules are used for small bowel visualization, the PillCam SB (Given Imaging, Yokneam, Israel), the EndoCapsule (Olympus Corporation, Allentown, PA), and the MiroCam (IntroMedic Co, Ltd, Seoul, South Korea). Unlike other available capsules that transmit images using ultrahigh frequency band radio telemetry, the MiroCam, uses electric field propagation to transmit the images. A fourth capsule, the PillCam ESO (Given Imaging), is used for visualization of the esophagus. Finally, there is a capsule used for visualization of the colon (PillCam COLON, Given Imaging) that has FDA approval for examination of the colon in patients who have failed colonoscopy.

The small bowel and esophageal capsules are approximately 11 × 26 mm in size, whereas the colon capsule is 11 × 31 mm. The small bowel capsules have fields of view that vary from 145 to 170 degrees. The capsules acquire between two and six frames per second, with battery lives between 8 and 12 hours. The capsules’ resolution allows for visualization of individual villi. The esophageal capsule has cameras at both ends and acquires 18 images per second, with a battery life of 20 minutes. Finally, like the esophageal capsule, the colon capsule has cameras at both ends. It acquires four images per second, with a battery life of about 10 hours. The colon capsule initially records for 5 minutes and then enters a “sleep mode,” reactivating after 2 hours. This is done to maximize colon visualization.

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Indications

The indications for small bowel, esophageal, and colonic capsule endoscopy are summarized in Table 34–1.

Table 34–1.Indications for small bowel, esophageal, and colon capsule endoscopy.

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