Abstract

Three-dimensional (3D) reconstruction of capsule endoscopic images has been attempted for a long time to obtain more information on small bowel structures. Due to the limited hardware resources of capsule size and battery capacity, software approaches have been studied but have mainly exhibited inherent limitations. Recently, stereo camera-based capsule endoscopy, which can perform hardware-enabled 3D reconstruction, has been developed. We aimed to evaluate the feasibility of newly developed 3D capsule endoscopy in clinical practice. This study was a prospective, single-arm, feasibility study conducted at two university-affiliated hospitals in South Korea. Small bowel evaluation was performed using a newly developed 3D capsule endoscope for patients with obscure gastrointestinal bleeding, suspected or established Crohn’s disease, small bowel tumors, and abdominal pain of unknown origin. We assessed the technical limitations, performance, and safety of the new capsule endoscope. Thirty-one patients (20 men and 11 women; mean age: 44.5 years) were enrolled. There was no technical defect preventing adequate visualization of the small bowel. The overall completion rate was 77.4%, the detection rate was 64.5%, and there was no capsule retention. All capsule endoscopic procedures were completed uneventfully. In conclusion, newly developed 3D capsule endoscopy was safe and feasible, showing similar performance as conventional capsule endoscopy. Newly added features of 3D reconstruction and size measurement are expected to be useful in the characterization of subepithelial tumours.

Highlights

  • Three-dimensional (3D) reconstruction of capsule endoscopic images has been attempted for a long time to obtain more information on small bowel structures

  • Due to the limited hardware resources pertaining to capsule size and battery capacity, there has been no hardware-enabled 3D reconstruction to date

  • Inability to control capsular movement is one of the major drawbacks of current capsule endoscopy. Due to this innate limitation, the characterization of small bowel lesions has been difficult in some cases, unlike conventional fibreoptic endoscopy, which can aerate, palpate, measure size, and acquire tissue

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Summary

Introduction

Three-dimensional (3D) reconstruction of capsule endoscopic images has been attempted for a long time to obtain more information on small bowel structures. Due to its passive movement and uncontrolled air insufflation, characterization of excavated or polypoid lesions is difficult in some cases (e.g., differentiation of mass and mucosal bulges)[4] To solve these problems, the three-dimensional (3D) reconstruction of the capsule image has been attempted but has shown limited utility so far[4,5]. IntroMedic Company (Seoul, South Korea) has developed a new stereo camera-based capsule endoscope, which is the first hardware-enabled 3D capsule endoscopy device This instrument can estimate the geometric structure of the small bowel, making it possible to reconstruct the 3D structure and accurately estimate the size of an object within a 10% relative error to the actual size[8]. We aimed to evaluate the feasibility of this newly developed 3D capsule endoscope in clinical practice

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