1113 ASSESSMENT OF CAPSULE ENDOSCOPY UTILIZING CAPSOCAM PLUS® IN PATIENTS WITH SUSPECTED SMALL BOWEL DISEASE INCLUDING PILOT STUDY WITH REMOTE ACCESS PATIENTS

Abstract

Capsule endoscopy (CE) has been widely utilized for the assessment of patients with known/suspected small bowel disease. The CapsoCam Plus® capsule is unique in that it utilizes four cameras at sequential 90 degree intervals in its mid-section permitting a 360-degree panoramic perspective with a 15+ hour battery life. A panoramic view has been suggested to improve overall visualization of the small bowel (SB) therefore potentially improving diagnostic yield. Unlike other small bowel capsules, it must be retrieved upon excretion (utilizing a magnetic kit) since the images are stored on the device. To assess the use of CapsoCam Plus in patients referred for suspected small bowel disease, including pilot assessments for patients in remote locations. A retrospective chart review (01/16 – 10/19) assessing consecutive capsule procedures utilizing this device was performed. Information acquired included basic demographics, indication, extent of examination, gastric transit time, small bowel transit time, yield, adverse events, capsule retention, recovery rates and recommendations for follow up. A pilot study was also initiated for patients in rural centers to access capsule testing remotely through mail courier without attendance/travel to the primary dispensing site. Acquired data included 65 patients receiving CapsoCam Plus®. Indications: 86% obscure gastrointestinal bleeding, 5% abdominal pain and 1% for IBD. 92% of studies were completed to cecal visualization. Mean gastric and small bowel transit time were 0:48:03 and 3:53:00. 95% were retrieved using retrieval kits provided to patients. 1.5% retrieved endoscopically from the stomach (retained due to pyloric stenosis), 1.5% retained in terminal ileum (previously undiagnosed stricture) and 1.5% not retrieved due to failure of patient to use retrieval kit. 74% of studies were normal SB, 12% contained SB ulceration/erosive disease and 8% did not demonstrate the entire small bowel. Recommendations for follow up included supportive therapy (52%), more aggressive iron supplementation (1%), repeat capsules (17%), further endoscopic evaluation (11%) and 12% for routine office follow up and discussion. All four capsules mailed to patients in remote communities were completed successfully. CapsoCam Plus® had a high retrieval rate of 95% demonstrating that with appropriate patient selection, recovery rates are very high. Only 3% of patients had retained capsules. Most patients in this study had a normal small bowel, however; images and completion rates were adequate to assess small bowel in the vast majority of patients. Success was obtained with mailing this capsule to remote sites sparing the patient travel to the dispensing site.