China
Africa
Explore chapters and articles related to this topic
Telescopes for Inner Space: Fiber Optics and Endoscopes
Published in Suzanne Amador Kane, Boris A. Gelman, Introduction to Physics in Modern Medicine, 2020
Suzanne Amador Kane, Boris A. Gelman
An alternative to using endoscopes for imaging parts of the gastrointestinal tract is video capsule endoscopy employing a self-contained “camera pill” (Figure 2.19). Just as it sounds, this device is a tiny self-contained camera, light source, and video transmitter all in one compact, roughly 1-cm-long package. Patients swallow the camera pill in a doctor's office, then go about their daily activities while it makes its way through the digestive tract, moving by the natural method of peristalsis and taking a series of images two times a second as it goes. The patient wears about the waist a data recorder that receives and records transmitted images from the camera pill for later analysis. Video capsule endoscopy is useful for imaging parts of the digestive tract, such as the deeper reaches of the small intestine, difficult to access using endoscopes, and has FDA approval for such examinations in the US. Despite its small size, the resolution of the camera pill is 0.1 mm, only somewhat coarser than regular endoscopy. Some drawbacks relative to colonoscopy or endoscopy of the upper gastrointestinal tract include the lack of ability to select the orientation of images, the inability to sample tissues for biopsy, and clinical approval only for small intestine imaging thus far. The next generation of active capsule endoscopy is slated to address some of these problems with devices that can propel and steer themselves.
Gastrointestinal Tract polyps and polyposis Syndromes
Published in John F. Pohl, Christopher Jolley, Daniel Gelfond, Pediatric Gastroenterology, 2014
Katharine Eng, Marsha Kay, Robert Wyllie
Endoscopic surveillance should include an upper endoscopy and colonoscopy starting at 8 years of age, or earlier if symptomatic. If polyps are noted, endoscopic examinations should be repeated every 2–3 years. Some form of examination of the small bowel is also needed, such as wireless video capsule endoscopy, magnetic resonance enterography, or barium study. The location and sizes of the polyps will influence their management. It is important to note that endoscopic or surgical resection of polyps does not lower the cancer risk, is not curative or always possible, and it is performed primarily for the complications, or to avoid the complications of PJS polyps.
Diagnostic yield for video capsule endoscopy in gastrointestinal graft- versus -host disease: a systematic review and metaanalysis
Published in Scandinavian Journal of Gastroenterology, 2023
Jonas Varkey, Viktor Jonsson, Eva Hessman, Thomas De Lange, Per Hedenström, Mihai Oltean
Video capsule endoscopy (VCE) has, since its introduction in clinical practice two decades ago [1], become the golden standard in diagnosing a broad range of small intestinal disorders where other diagnostic approaches have failed to provide a valid diagnosis [2,3]. Recent technical improvements, its increasingly affordable price and above all, its ability to visualize in detail the intestinal segments outside of the reach of traditional endoscopy has turned it into the investigation modality of choice for a growing list of small intestinal disorders [4,5]. In short, VCE is useful in diagnosing occult bleeding and small mucosal lesions (small bowel tumours, vascular malformations) that are otherwise not visible through standard imaging examinations [6,7]. At the same time, the list of contraindications has become shorter, and the only current absolute contraindication is gastrointestinal tract obstruction and known fibrotic strictures. Implantable cardiac devices (pacemakers, internal defibrillators, and left-ventricular assist devices), dysmotility or previous gastrointestinal surgery are no longer considered as absolute contraindications [8,9].
Assessment of endoscopic response using pan-enteric capsule endoscopy in Crohn’s disease; the Sensitivity to Change (STOC) study
Published in Scandinavian Journal of Gastroenterology, 2022
Adriaan Volkers, Peter Bossuyt, Jitteke de Jong, Lieven Pouillon, Krisztina Gecse, Marjolijn Duijvestein, Cyriel Ponsioen, Geert D’Haens, Mark Löwenberg
Endoscopic remission is associated with improved outcomes in Crohn’s disease (CD), such as prolonged steroid-free clinical remission and reduced hospitalization and surgery rates [1]. Therefore, treatment goals in CD patients have evolved from symptom control to healing of mucosal lesions, visualized by ileocolonoscopy. Potent therapeutic agents, such as anti-tumor necrosis factor (TNF) agents, have made restoration of mucosal integrity achievable [2,3]. A recent study revealed that vedolizumab, a gut-selective biological targeting α4β7-integrins, can also induce endoscopic remission in CD [4]. Ileocolonoscopy is the gold standard for assessing luminal disease activity in CD patients and is often used to monitor treatment effects in the colon and terminal ileum. However, ileocolonoscopy is time consuming, expensive, unpleasant for patients and it carries a complication risk [5,6]. Video capsule endoscopy has several advantages compared to ileocolonoscopy, including the absence of sedation and anesthesia, the possibility to assess the entire gastrointestinal tract and the noninvasive technology [7]. Prior work revealed that capsule endoscopy was better tolerated than ileocolonoscopy [8]. Therefore, video capsule endoscopy might provide an attractive alternative imaging modality to monitor treatment effects in CD.
Monitoring established Crohn’s disease with pan-intestinal video capsule endoscopy in Europe: clinician consultation using the nominal group technique
Published in Current Medical Research and Opinion, 2021
Cristina Carretero, Franck Carbonnel, Marc Ferrante, Torben Knudsen, Nancy Van Lent, Alan J. Lobo, Lucian Negreanu, Ana Vojvodic, Salvatore Oliva
Video capsule endoscopy has the potential to address many limitations of other diagnostic modalities. Clinicians perceived the ability to perform PCE in a single procedure as the most important comparative benefit. The second most important comparative benefit of PCE was considered its ability to visualize the small bowel and colonic mucosa directly and with higher sensitivity. Compared to PCE, magnetic resonance enterography (MRE) presents with comparable diagnostic accuracy for small bowel disease and enables visualization of transmural and extramural abnormalities41. However, MRE presents with a lower accuracy for mucosal inflammation42, where its ability to monitor response to therapy has yet to be determined43. Finally, the available magnetic resonance index of activity (MaRIA) has only been validated on the terminal ileum and colonic segments44.