Current practice and future directions of capsule endoscopy: Progress of capsule endoscopy

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  • カプセル内視鏡の現在と未来―カプセル内視鏡検査はここまで進んでいる―

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Before the development of capsule endoscopy (CE) and balloon enteroscopy (BE), the small bowel could be explored only by poorly effective methods, such as small bowel series. The small bowel was the so-called “Dark Incontinent”. In CE, the sensors are placed on the abdomen using sticky patches and connected by wires to a recording device. A patient swallows a capsule with water at the hospital. The primary use of CE is to examine the small intestine that cannot be seen by other types of endoscopy such as colonoscopy or EGD. Colon capsule endoscopy (Pillcom® Colon 2) was developed particularly to increase the acceptability and safety of colonic examination. The Agile Patency Capsule is the same size as the PillCam® capsule and is used to determine whether the PillCam® capsule can pass freely through the digestive tract. Obtaining a tissue sample is the next logical step once the capsule can be accurately maneuvered around a lesion and thus would prevent the need for a conventional endoscopy and biopsy when an abnormality is diagnosed by CE. Optical biopsy may enable accurate pathological diagnosis. CE is now an invaluable tool for investigating the small bowel since it outperforms other new investigation modalities. However, esophageal, colonic and potentially gastric capsule examinations require further improvement for them to be comparable to or even better than their traditional investigational counterparts.

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