Wireless Capsule Endoscopy

n May of 2000, a short paper appeared in the journal Nature describing a new form of gastrointestinal endoscopy that was performed with a miniaturized, swallowable camera that was able to transmit color, high-fidelity images of the gastrointestinal tract to a portable recording device. 1 The article highlighted the ability of the device to image the entire small bowel, a prospect that had been difficult with preexisting endoscopic technology. The device, known as the M2A Imaging System (Given Imaging, Atlanta, GA), quickly generated widespread interest within the gastrointestinal community as a means of investigating small bowel disease. The following year, the device was granted approval by the US Food and Drug Administration for use in humans, and it is now widely available in the United States. At present, the exact role of wireless endoscopy is still being defined. Few well-constructed clinical studies have been performed to date to formally assess the indications, sensitivity, specificity, and clinical utility of the device, but some encouraging data from animal studies have been published with regard to the ability of the device to successfully locate small bowel abnormalities. 2 This article reviews the fundamentals of wireless capsule endoscopy. Special attention is paid to the indications, benefits, and drawbacks of the technique, as well as to the strengths and limitations of clinical data available to date. THE CAPSULE ENDOSCOPY SYSTEM The capsule endoscopy system is composed of several key parts: the capsule itself, a portable image receiver/ recorder unit and battery pack, and a specially modified computer workstation.