Clinical Review

Science, medicine, and the future

Capsule endoscopy

BMJ 2009; 339 doi: 10.1136/bmj.b3420 (Published 11 September 2009)
Cite this as: BMJ 2009;339:b3420

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  1. Andrea Moglia, researcher1,
  2. Andrea Pietrabissa, associate professor12,
  3. Alfred Cuschieri, professor of surgery and chief scientific advisor34
  1. 1EndoCAS, Center for Computer Assisted Surgery, University of Pisa, 56124 Pisa, Italy
  2. 2Department of Oncology, Transplantation and New Technology in Medicine, University of Pisa
  3. 3Institute for Medical Science and Technology, University of Dundee, Dundee Medipark, Dundee DD2 1FD
  4. 4Scuola Superiore Sant’Anna di Studi Universitari, Piazza Martiri della Libertà 33, 56127, Pisa, Italy
  1. Correspondence to: A Moglia andrea.moglia{at}endocas.org
  • Accepted 4 August 2009

Summary points

  • Capsule endoscopy requires patients to ingest a vitamin sized pill containing a camera that provides images of the gastrointestinal mucosa

  • Capsule endoscopy is complementary to double balloon endoscopy for detecting obscure gastrointestinal bleeding and small intestinal tumours

  • Oesophageal capsule endoscopy is a safe alternative to upper gastrointestinal endoscopy in the surveillance of patients with Barrett’s oesophagus, although cost may limit its use

  • Colonic capsule endoscopy may be useful in the detection of colorectal cancer when colonoscopy is incomplete or contraindicated

  • Magnetically guided capsules may be useful in cystoscopy and as the imaging platform for natural orifice transluminal endoscopic surgery

  • Technological challenges for the next generation of devices include reducing component size, improving power management, and introducing capsule locomotion

Capsule endoscopy was unveiled at Digestive Disease Week 2000 in San Diego, California, USA, by Paul Swain, gastroenterologist at Imperial College St Mary’s Hospital, London, and Given Imaging, a Yoqneam (Israel) company, as the product of collaborative research and development activities between the two groups.1 The past few years have seen advances in this technology, which is now part of established clinical practice in North America, Europe, the Far East, and Australia, particularly for imaging the small bowel. This article describes current clinical applications of capsule endoscopy and looks at future developments.

Sources and selection criteria

We searched PubMed and ISI Web of Knowledge for relevant articles. We included articles published in English language journals from January 2006 to April 2009 and used the following search terms: capsule endoscopy and technology, capsule endoscopy for gastrointestinal bleeding, capsule endoscopy for Crohn’s disease, capsule endoscopy for coeliac disease, capsule endoscopy for small bowel tumours, oesophagus capsule endoscopy, and colon capsule.

What is capsule endoscopy?

Capsule endoscopy is performed by ingestion of a small (26×11 mm) disposable battery powered pill containing a complementary metal oxide semiconductor camera (fig 1⇓), which provides …

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