Capsule endoscopy (PillCam, EndoCapsule, CapsoCam)
A camera the size of a large vitamin pill that the patient swallows; it photographs the whole small intestine, which ordinary endoscopes cannot reach, and newer versions look at the colon as an alternative to colonoscopy for people who cannot or will not have one.
Overview
Given Imaging's PillCam, approved in 2001 and now sold by Medtronic, packs one or two cameras, LEDs, a battery and a radio transmitter into a capsule that records tens of thousands of frames as peristalsis carries it through the gut, sent to a recorder worn on a belt. Olympus's EndoCapsule and CapsoVision's CapsoCam (which stores images on board with a wraparound view) compete, and magnetically steered capsules such as AnX Robotica's NaviCam examine the stomach. In oncology the small-bowel capsule investigates unexplained bleeding and iron-deficiency anaemia where a small-bowel tumour is possible, surveys polyposis syndromes such as Peutz-Jeghers and Lynch syndrome, and follows coeliac patients at risk of lymphoma; colon capsules are offered where colonoscopy is refused, incomplete or unavailable, and the NHS piloted them during the pandemic backlog. Artificial-intelligence reading software is cutting the hour a physician spends reviewing each video.
The capsule cannot take biopsies, wash the mucosa or remove polyps, so any finding leads to a conventional endoscopy; it may be retained above a stricture, its detection of flat lesions is lower than colonoscopy's, colon preparation is harder than for colonoscopy, and reading time is long. It is a triage tool, not a replacement for the endoscope.
- NIR camera + excitation
- Fluorescent tumour margin
How it works
A swallowed capsule with cameras, illumination and a transmitter or on-board memory images the mucosa as it transits passively or under magnetic steering, producing a video read by a clinician with increasing help from AI detection software.
- Visualises the entire small bowel
- Non-invasive, no sedation
- Alternative for patients who cannot have colonoscopy
- No biopsy or therapy
- Capsule retention above strictures
- Long reading time and lower detection of flat lesions
Latest papers
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