| International Session（Symposium）8(JGES・JSGE・JSGS・JSGCS) |
| Sat. November 23rd 14:30 - 17:00 Room 11: Portopia Hotel South Wing Topaz |
| Evaluation of Current Status and Near Future Perspectives of Capsule Endoscopy | |||
| Yun Jeong Lim | |||
| Dongguk University Ilsan Hospital | |||
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| Capsule endoscopy (CE) was developed by Gavriel Iddan and Paul Swain in 2001. Small bowel CE was introduced in Korea in 2002, and the Korean Capsule/Gut Image Study Group (formerly, Korean Gut Image Study Group) was founded in 2003. The Korean Capsule Endoscopy Registry, was established in 2003. Approximately 5,000 cases of small bowel CE have been collected through the Korean Capsule Endoscopy Registry. Since 2004, people in Korea with small bowel CE have been provided with insurance benefits, in case of obscure GI bleeding, namely, small bowel bleeding. Last year, the Korean government expanded insurance benefits to people with suspected or confirmed small bowel Crohn’s disease, and small bowel polyposis or tumor. In Korea, MiroCam (Intromedic, Korea) and PillCam (Medtronic, USA), have been used for small bowel evaluation. MiroCam was developed in 2007. Recently, MiroCam developed 3D image, and improved image resolution, by deburring. Lesion size estimation and more accurate information about lesion localization are possible, with the newly developed 3-D image CE system. CE and the Korean FDA have approved the 3-D image CE system of MiroCam. In Crohn’s disease, CE with capability of simultaneous examination for the small as well as large bowel, is expected to be considerably useful. Prediction of capsule retention is critical in Crohn’s disease. In Korea, MR/ or CT enterography, not the patency capsule, have been used, to avoid capsule retention. The patency capsule has been approved by the KFDA. Patency capsules have rarely caused small bowel perforation in the case of Crohn’s disease with small bowel stenosis. Due to being patient-friendly, non-invasive, and safe requiring no sedation, CE will replace screening endoscopy, if technological advances overcome the many limitations of the current CE, for example, no active control, no air insufflation, long interpretation time, and so on. As you know, esophageal and colon CE had been developed by the Medtronic Company. In Korea, the colon capsule has not been approved by the KFDA. Ingestion of too much laxative, and relatively low total colon examination rate should be resolved, for widespread use of colon CE. Hopefully, colon CE will be used in cases of failed colonoscopy or refusal of colonoscopy, especially in the elderly in Korea. Magnetic-controlled CE (ANKON), has been used for stomach evaluation in China. Capsule movement can be controlled with a hand-held external magnet (Intromedic company) though transmission of human body communication. Gastric CE showed accuracy comparable to that of conventional gastroscopy. But, detection of fundus lesion was inferior because of weak intensity of illumination. We boldly predict that the entire GI tract will be evaluated with CE (pan-endoscopy) in the future. |
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Index Term 1: Capsule endoscopy Index Term 2: small intestinal disease |
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