Wireless capsule endoscopy: from diagnostic devices to multipurpose robotic systems

In the recent past, the introduction of miniaturised image sensors with low power consumption, based on complementary metal oxide semiconductor (CMOS) technology, has allowed the realisation of an ingestible wireless capsule for the visualisation of the small intestine mucosa. The device has received approval from Food and Drug Administration and has gained momentum since it has been more successful than traditional techniques in the diagnosis of small intestine disorders. In 2004 an esophagus specific capsule was launched, while a solution for colon is still under development. However, present solutions suffer from several limitations: they move passively by exploiting peristalsis, are not able to stop intentionally for a prolonged diagnosis, they receive power from an internal battery with short length, and their usage is restricted to one organ, either small bowel or esophagus. However the steady progresses in many branches of engineering, including microelectromechanical systems (MEMS), are envisaged to affect the performances of capsular endoscopy. The near future foreshadows capsules able to pass actively through the whole gastrointestinal tract, to retrieve views from all organs and to perform drug delivery and tissue sampling. In the long term, the advent of robotics could lead to autonomous medical platforms, equipped with the most advanced solutions in terms of MEMS for therapy and diagnosis of the digestive tract. In this review, we discuss the state of the art of wireless capsule endoscopy (WCE): after a description on the current status, we present the most promising solutions.

[1]  P. Dario,et al.  Shape memory alloy clamping devices of a capsule for monitoring tasks in the gastrointestinal tract , 2005 .

[2]  A. Hara,et al.  A Meta-Analysis of the Yield of Capsule Endoscopy Compared to Other Diagnostic Modalities in Patients with Obscure Gastrointestinal Bleeding , 2005, The American Journal of Gastroenterology.

[3]  Lan-Rong Dung,et al.  An ultra-low-power image compressor for capsule endoscope , 2006, Biomedical engineering online.

[4]  R. Fass,et al.  Ambulatory Esophageal pH Monitoring: New Directions , 2006, Digestive Diseases.

[5]  B. Lewis,et al.  AGA technical review on the evaluation and management of occult and obscure gastrointestinal bleeding. , 2000, Gastroenterology.

[6]  Paul L Gourley,et al.  Brief Overview of BioMicroNano Technologies , 2008, Biotechnology progress.

[7]  L. Holm,et al.  The adherent gastrointestinal mucus gel layer: thickness and physical state in vivo. , 2001, American journal of physiology. Gastrointestinal and liver physiology.

[8]  Jane Bradbury Journey to the centre of the body , 2000, The Lancet.

[9]  G Costamagna,et al.  A novel diagnostic tool for detecting functional patency of the small bowel: the Given patency capsule. , 2005, Endoscopy.

[10]  Michael Vieth,et al.  Prevalence of Barrett's esophagus in the general population: an endoscopic study. , 2005, Gastroenterology.

[11]  Yoshihiro Kusuda,et al.  A further step beyond wireless capsule endoscopy , 2005 .

[12]  G. Iddan,et al.  History and development of capsule endoscopy. , 2004, Gastrointestinal endoscopy clinics of North America.

[13]  D. Cave,et al.  Technology Insight: current status of video capsule endoscopy , 2006, Nature Clinical Practice Gastroenterology &Hepatology.

[14]  Rashid Bashir,et al.  BioMEMS: state-of-the-art in detection, opportunities and prospects. , 2004, Advanced drug delivery reviews.

[15]  W. Qureshi Current and future applications of the capsule camera , 2004, Nature Reviews Drug Discovery.

[16]  Amy K Hara,et al.  Crohn disease of the small bowel: preliminary comparison among CT enterography, capsule endoscopy, small-bowel follow-through, and ileoscopy. , 2006, Radiology.

[17]  Paolo Dario,et al.  Modeling and Experimental Validation of the Locomotion of Endoscopic Robots in the Colon , 2004, Int. J. Robotics Res..

[18]  K. Arai,et al.  Fabrication of magnetic actuator for use in a capsule endoscope , 2003 .

[19]  Dorian Liepmann,et al.  Microfabricated Polysilicon Microneedles for Minimally Invasive Biomedical Devices , 2000 .

[20]  A. Uehara,et al.  Capsule endoscope NORIKA system , 2002, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[21]  J. Leighton,et al.  Safety of Wireless Capsule Endoscopy in Patients with Implantable Cardiac Defibrillators , 2005, The American Journal of Gastroenterology.

[22]  A Van Gossum,et al.  Video capsule endoscopy in small-bowel malignancy: a multicenter Belgian study. , 2006, Endoscopy.

[23]  J. A. Leighton,et al.  ICCE consensus for inflammatory bowel disease. , 2005, Endoscopy.

[24]  D. Cave Reading wireless video capsule endoscopy. , 2004, Gastrointestinal endoscopy clinics of North America.

[25]  B. Petersen,et al.  ASGE Technology Status Evaluation Report: wireless capsule endoscopy. , 2006, Gastrointestinal endoscopy.

[26]  Ichiko Fuyuno Olympus finds market rival hard to swallow , 2005, Nature.

[27]  M Pennazio,et al.  ICCE consensus for obscure gastrointestinal bleeding. , 2005, Endoscopy.

[28]  Jorma Ilonen,et al.  Prevalence of Celiac disease among children in Finland. , 2003, The New England journal of medicine.

[29]  C. Swain,et al.  Electrical stimulation for propelling endoscopes. , 2001, Gastrointestinal endoscopy.

[30]  Jin-Ho Cho,et al.  New Method of Moving Control for Wireless Endoscopic Capsule Using Electrical Stimuli , 2005, IEICE Trans. Fundam. Electron. Commun. Comput. Sci..

[31]  Hymie Kavin,et al.  Successful Wireless Capsule Endoscopy for a 2.5-Year-Old Child: Obscure Gastrointestinal Bleeding From Mixed, Juvenile, Capillary Hemangioma-Angiomatosis of the Jejunum , 2006, Pediatrics.

[32]  E McDougall Minimally invasive therapy. , 1995, The Journal of urology.

[33]  R. McNeill Alexander Winging their way , 2000, Nature.

[34]  F. Miller,et al.  Videocapsule Endoscopy versus Barium Contrast Studies for the Diagnosis of Crohn's Disease Recurrence Involving the Small Intestine , 2004, The American Journal of Gastroenterology.

[35]  David Moher,et al.  The prevalence of celiac disease in average-risk and at-risk Western European populations: a systematic review. , 2005, Gastroenterology.

[36]  D Kennedy,et al.  Breakthrough of the Year , 2003, Science.

[37]  P. Swain,et al.  Wireless capsule endoscopy. , 2002, The Israel Medical Association journal : IMAJ.

[38]  D. Cave,et al.  ICCE Consensus for Bowel Preparation and Prokinetics , 2005, Endoscopy.

[39]  Paul Swain,et al.  Colonoscopy: new designs for the future. , 2005, Gastrointestinal endoscopy clinics of North America.

[40]  C. Gutschow,et al.  Demographic variations in the rising incidence of esophageal adenocarcinoma in white males , 2001, Cancer.

[41]  D. Rex,et al.  Performance of given suspected blood indicator , 2003, American Journal of Gastroenterology.

[42]  D L Polla,et al.  Microdevices in medicine. , 2000, Annual review of biomedical engineering.

[43]  M. Cima,et al.  A controlled-release microchip , 1999, Nature.

[44]  J. Barkin,et al.  Wireless Capsule Endoscopy requiring surgical intervention: the world’s experience , 2002 .

[45]  Elazer R. Edelman,et al.  Adv. Drug Delivery Rev. , 1997 .

[46]  H. Lochs,et al.  Does Passage of a Patency Capsule Indicate Small-Bowel Patency? A Prospective Clinical Trial? , 2005, Endoscopy.

[47]  R. Salmore Our heritage: a history of gastroenterology and gastroenterology nursing. , 1998, Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates.

[48]  G. Iddan,et al.  Wireless capsule endoscopy , 2003, Gut.

[49]  A. Glukhovsky,et al.  Future of capsule endoscopy. , 2004, Gastrointestinal endoscopy clinics of North America.

[50]  R. Eliakim,et al.  A novel diagnostic tool for detecting oesophageal pathology: the PillCam oesophageal video capsule , 2004, Alimentary pharmacology & therapeutics.

[51]  Anand Kesari,et al.  Video capsule endoscopy and celiac disease. , 2005, Gastrointestinal endoscopy.

[52]  N. M. Kelly,et al.  Wireless capsule endoscopy – A new tool for investigation of suspected gastrointestinal bleeding , 2005 .

[53]  Paul Swain,et al.  Radiocontrolled Movement of a Robot Endoscope in the Human Gastrointestinal Tract , 2005 .

[54]  G. Meron The development of the swallowable video capsule (M2A). , 2000, Gastrointestinal endoscopy.

[55]  P. Moayyedi,et al.  Recent developments in gastroenterology , 2002, BMJ : British Medical Journal.

[56]  D Regent,et al.  Temporary intestinal occlusion induced by a "patency capsule" in a patient with Crohn's disease. , 2005, Endoscopy.