Endoscopic placement of the small-bowel video capsule by using a capsule endoscope delivery device

Background: Capsule endoscopy performed via the traditional peroral route is technically challenging in patients with dysphagia, gastroparesis, and/or abnormal upper-GI (UGI) anatomy. Objective: To describe the indications and outcomes of cases in which the AdvanCE capsule endoscope delivery device, which has recently been cleared by the Food and Drug Administration, was used. Design: Retrospective, descriptive, case series. Setting: Tertiary care, university hospital. Patients: We report a case series of 16 consecutive patients in whom the AdvanCE delivery device was used. The study period was May 2005 through July 2006. Interventions: Endoscopic delivery of the video capsule to the proximal small bowel by using the AdvanCE delivery device. Main Outcome Measurements: Indications, technique, and completeness of small bowel imaging in patients who underwent endoscopic video capsule delivery. Results: The AdvanCE delivery device was used in 16 patients ranging in age from 3 to 74 years. The primary indications for endoscopic delivery included inability to swallow the capsule (10), altered UGI anatomy (4), and gastroparesis (2). Of the 4 patients with altered UGI anatomy, 3 had dual intestinal loop anatomy (ie, Bilroth-II procedure, Whipple surgery, Roux-en-Y gastric bypass) and 1 had a failed Nissen fundoplication. in all cases, the capsule was easily deployed without complication, and complete small intestinal imaging was achieved. Limitations: Small patient size. Conclusions: Endoscopic placement of the Given PillCam by use of the AdvanCE delivery device was safe and easily performed in patients for whom capsule endocsopy would otherwise have been contraindicated or technically challenging.