Capsule Endoscopy System Research Articles

A miniature capsule endoscope based on spiral antenna with wireless sensing capabilities

Abstract In this paper, a capsule endoscopy system with a sensing function is proposed for medical devices. A single-arm spiral antenna is designed for data transmission and is combined with the voltage controlled oscillator to achieve sensing capabilities. The designed antenna operates at a 900 MHz industrial scientific medical band. By establishing a three-layer cylindrical model of the stomach, it was concluded that the antenna in the stomach has a high peak gain of −1.1 dBi. Additionally, the antenna achieved a −10 dB impedance bandwidth of 5%. The capsule endoscopy was experimentally measured in both actual stomach and simulated environments. The maximum working distance of the capsule endoscope was measured to be 6.8 m. Additionally, the proposed capsule endoscope was tested for its sensing function using solutions with different dielectric constants. Finally, it was confirmed through link analysis that it has good communication capabilities. The results and analysis confirm that the proposed capsule endoscope can be used for examining gastric diseases.

Spectrum aided vision enhancer enhances mucosal visualization by hyperspectral imaging in capsule endoscopy.

Narrow-band imaging (NBI) is more efficient in detecting early gastrointestinal cancer than white light imaging (WLI). NBI technology is available only in conventional endoscopy, but unavailable in magnetic-assisted capsule endoscopy (MACE) systems due to MACE's small size and obstacles in image processing issues. MACE is an easy, safe, and convenient tool for both patients and physicians to avoid the disadvantages of conventional endoscopy. Enabling NBI technology in MACE is mandatory. We developed a novel method to improve mucosal visualization using hyperspectral imaging (HSI) known as Spectrum Aided Visual Enhancer (SAVE, Transfer N,Hitspectra Intelligent Technology Co., Kaohsiung, Taiwan). The technique was developed by converting the WLI image captured by MACE to enhance SAVE images. The structural similarity index metric (SSIM) between the WLI MACE images and the enhanced SAVE images was 91%, while the entropy difference between the WLI MACE images and the enhanced SAVE images was only 0.47%. SAVE algorithm can identify the mucosal break on the esophagogastric junction in patients with gastroesophageal reflux disorder. We successfully developed a novel image-enhancing technique, SAVE, in the MACE system, showing close similarity to the NBI from the conventional endoscopy system. The future application of this novel technology in the MACE system can be promising.

Novel ultrasound capsule endoscopy for gastrointestinal scanning: An in vivo animal study.

EUS is an important modality for diagnosis and assessment of gastrointestinal (GI) subepithelial lesions. However, EUS is invasive and operator-dependent and requires sedation in most cases. The newly developed ultrasound capsule endoscopy (USCE) system, with both white-light and ultrasound imaging modalities, is a minimally invasive method for superficial and submucosal imaging of the esophagus. This animal study aimed to evaluate the feasibility and efficacy of the USCE system for upper GI tract and small bowel scanning. Three Bama miniature pigs were selected to scan their esophagus, stomach, small bowel, and simulated submucosal lesions. USCE was performed first, followed by EUS. The feasibility of USCE was measured by obtaining ultrasound images of normal GI walls and submucosal lesions under the guidance of optical viewing. The efficacy of USCE was evaluated by comparing tissue structures and lesion features shown on ultrasound images obtained with both instruments. Under the optical mode of USCE, the GI tract was well visualized, and all simulated lesions were located. Clear ultrasound images of normal GI tract and submucosal lesions were acquired. Ultrasound images of the esophagus, stomach, and small bowel were characterized by differentiated multilayer structures on USCE, which was consistent with the structures displayed on EUS. And the visualization of submucosal lesions, using both USCE and EUS, was characterized by a hypoechoic and well-demarcated mass in the layer of submucosa. This animal study indicated the feasibility and potential clinical efficacy of this USCE for simultaneous optical mucosal visualization and transmural ultrasound imaging of upper GI tract and small bowel, providing possibility of using this technology for a wider range of GI tract.

Capsule endoscopy for small bowel bleed: Current update.

Small intestine, hitherto an obscure area for endoscopists before 2000, is now easily evaluated non-invasively using capsule endoscopy and invasively by device-assisted enteroscopies. Major advances in understanding the causes and management of small bowel diseases have been in obscure gastrointestinal (GI) bleed, currently re-named as small bowel bleed, after the discovery of capsule endoscopy. The current article is a narrative review of the technology of capsule endoscopy, its advantages and limitations, future perspective and Indian studies on its utility in patients with small bowel bleed. Till date, eight large series reporting 2319 patients with obscure GI bleed (1554 overt and 765 occult) undergoing capsule endoscopy have been reported from India. Overall yield of capsule endoscopy to detect lesions in these studies varied from 43.5% to 90%. The major causes detected in various studies for small bowel bleed include vascular malformation, portal hypertensive enteropathy, ulcer, stricture, tumor, polyps, etc. Hookworm can cause both occult as well as overt small bowel bleed as shown mainly from India. Capsule endoscopy has also been quite safe in patients with small bowel bleed as despite 0.6% to15% retention of imaging capsule in Indian studies, development of clinically evident small bowel obstruction has rarely been reported. The major limitations of capsule endoscopy include lack of maneuvrability and therapeutic capability. Research is in progress to overcome some of the limitations of the current capsule endoscopy system. It is concluded that discovery of capsule endoscopy has brought a new paradigm in GI endoscopy and explored a hitherto unexplored area of GI tract, i.e. small bowel that continued to be a black box for the endoscopists.

Prospective, multicenter, self-controlled clinical trial on the effectiveness and safety of a cable-transmission magnetically controlled capsule endoscopy system for the examination of upper GI diseases

Many GI disorders and precancerous conditions often present asymptomatically, leading to delayed patient diagnoses and treatment interventions. In this study, we developed a novel cable-transmission magnetically controlled capsule endoscopy (CT-MCCE) system for detecting GI diseases and assessed its safety and feasibility through clinical trials. This prospective, multicenter trial compared CT-MCCE with conventional gastroscopy in patients aged 18 to 75 years with upper GI tract diseases between October 2022 and July 2023. The primary endpoints were the evaluation of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in the detection of focal lesions within the esophagus, stomach, and duodenal bulb using CT-MCCE. One hundred eighty individuals (mean age, 43.1 years; 52.22% women) were recruited from 3 hospitals in China. CT-MCCE detected lesions in the esophagus with a sensitivity of 97.22%, specificity of 100%, PPV of 100%, NPV of 98.18%, and accuracy of 98.89%; detected gastric focal lesions in the entire stomach with a sensitivity of 96.81%, specificity of 98.84%, PPV of 98.91%, NPV of 96.59%, and accuracy of 97.78%; and detected lesions in the duodenal bulb with a sensitivity of 100%, specificity of 100%, PPV of 100%, NPV of 100%, and accuracy of 100%. There were no significant differences between CT-MCCE and EGD regarding the cleanliness of the upper GI tract and visibility of the upper GI mucosa. However, CT-MCCE was associated with a lower incidence of discomfort than EGD (P< .001). The diagnostic performance of CT-MCCE is comparable with that of EGD in the completion of upper GI tract examinations and lesion detection. Furthermore, the improved tolerance of CT-MCCE in detecting upper GI diseases was noted without any observed adverse events. (Clinical trial registration number: ChiCTR2200063630.).

Conformal MIMO Ultrawideband Antenna Design for High-Speed Wireless Telemetry in Capsule Endoscopy Systems

Conformal MIMO Ultrawideband Antenna Design for High-Speed Wireless Telemetry in Capsule Endoscopy Systems

Design of a Compact Circularly Polarized Implantable Antenna for Capsule Endoscopy Systems.

This research proposes a miniature circular polarization antenna used in a wireless capsule endoscopy system at 2.45 GHz for industrial, scientific, and medical bands. We propose a method of cutting a chamfer rectangular slot on a circular radiation patch and introducing a curved radiation structure into the centerline position of the chamfer rectangular slot, while a short-circuit probe is added to achieve miniaturization. Therefore, we significantly reduced the size of the antenna and made it exhibit circularly polarized radiation characteristics. A cross-slot is cut in the GND to enable the antenna to better cover the operating band while being able to meet the complex human environment. The effective axis ratio bandwidth is 120 MHz (2.38-2.50 GHz). Its size is π × 0.032λ02 × 0.007λ0 (where λ0 is the free-space wavelength of at 2.4 GHz). In addition, the effect of different organs such as muscle, stomach, small intestine, and big intestine on the antenna when it was embedded into the wireless capsule endoscopy (WCE) system was further discussed, and the results proved that the WCE system has better robustness in different organs. The antenna's specific absorption rate can follow the IEEE Standard Safety Guidelines (IEEE C95.1-1999). A prototype is fabricated and measured. The experimental results are consistent with the simulation results.

Review on Wireless Capsule Endoscopy System Issues, Challenges, and Technologies

Review on Wireless Capsule Endoscopy System Issues, Challenges, and Technologies

The use of magnet-controlled capsule endoscopy as the initial diagnostic tool in patients with acute upper gastrointestinal bleeding.

The latest magnet-controlled capsule endoscopy (MCCE) system can examine the water-distended stomach, duodenum, and the small bowel. We assessed the use of MCCE as the first diagnostic tool in patients with acute upper gastrointestinal bleeding (AUGIB). This was a prospective cohort study that enrolled patients admitted with AUGIB from two teaching hospitals. Patients underwent MCCE as the initial diagnostic modality. Our primary endpoint was the diagnostic yield of MCCE. The subsequent care of these patients was guided by MCCE findings. Of 100 enrolled patients, 99 (mean age 54years, 70.7% men) with a median Glasgow-Blatchford score of 6 (IQR 3-9) underwent MCCE. In three patients, MCCE found active bleeding (two duodenal ulcers and Dieulafoy's lesion). The overall diagnostic yield of MCCE was 95.8% (92 lesions in 96 patients); five in the esophagus (Mallory Weiss tears 2, varices 1, and esophagitis 2), 51 in the stomach (gastric erosions 26, gastric ulcers 14, cancer 3, GIST 3, gastric polyps 3, antral vascular ectasia 1,angiodysplasia 1), 32 in the duodenum (ulcers 28, erosions 3, polyp 1), and four in the small bowel (ulcers 2, an erosion with a nonbleeding vessel 1, Meckel's diverticulum 1). Fifty-two (52.5%) patients were discharged without endoscopy. Forty-five (45.5%) patients underwent inpatient esophagogastroduodenoscopy (EGD), which found an antral ulcer and six duodenal ulcers in addition. In stable patients with AUGIB, MCCE can be used as a diagnostic tool. EGD should follow in patients with an inadequate view of the duodenum.

Dual-Polarized Transparent Antenna and Its Application for Capsule Endoscopy System

In this paper, we proposed a small transparent thin film antenna for a wireless capsule endoscopy system. The transparent thin film antenna is needed to provide a clear 360° broad-sight view of the wireless capsule system in the future. Furthermore, the transparent thin film is critical for performing the dual-polarized antenna operating at 2.45 GHz. The proposed transparent thin film uses the nano-alignment process to further achieve low resistivity from 3.78 × 10−4 Ω-cm to 9.14 × 10−5 Ω-cm and improves the transparency by over 70%. The nano-alignment process includes periodic electrodes with AC signals that can effectively rearrange the nano-material into an ordered arrangement, enhancing the thin film’s microwave characteristics. Due to applying to the capsule endoscopy system, the ability of water resistance is also considered in this design. Therefore, the O2 plasma treatment is used to improve the water contact angle from 76° to 31°, measured on the surface of the thin film. The proposed transparent antenna is designed to have a center frequency of 2.45 GHz, a bandwidth of 855 MHz, and an antenna gain of −26.3 dBi, and is helpful for capsule endoscopy systems.

Deep Learning and Minimally Invasive Endoscopy: Automatic Classification of Pleomorphic Gastric Lesions in Capsule Endoscopy.

Capsule endoscopy (CE) is a minimally invasive examination for evaluating the gastrointestinal tract. However, its diagnostic yield for detecting gastric lesions is suboptimal. Convolutional neural networks (CNNs) are artificial intelligence models with great performance for image analysis. Nonetheless, their role in gastric evaluation by wireless CE (WCE) has not been explored. Our group developed a CNN-based algorithm for the automatic classification of pleomorphic gastric lesions, including vascular lesions (angiectasia, varices, and red spots), protruding lesions, ulcers, and erosions. A total of 12,918 gastric images from 3 different CE devices (PillCam Crohn's; PillCam SB3; OMOM HD CE system) were used from the construction of the CNN: 1,407 from protruding lesions; 994 from ulcers and erosions; 822 from vascular lesions; and 2,851 from hematic residues and the remaining images from normal mucosa. The images were divided into a training (split for three-fold cross-validation) and validation data set. The model's output was compared with a consensus classification by 2 WCE-experienced gastroenterologists. The network's performance was evaluated by its sensitivity, specificity, accuracy, positive predictive value and negative predictive value, and area under the precision-recall curve. The trained CNN had a 97.4% sensitivity; 95.9% specificity; and positive predictive value and negative predictive value of 95.0% and 97.8%, respectively, for gastric lesions, with 96.6% overall accuracy. The CNN had an image processing time of 115 images per second. Our group developed, for the first time, a CNN capable of automatically detecting pleomorphic gastric lesions in both small bowel and colon CE devices.

A novel capsule endoscopy for upper and mid-GI tract: the UMGI capsule

Backgrounds and AimsComplete and consecutive observation of the gastrointestinal (GI) tract continues to present challenges for current endoscopy systems. We developed a novel upper and mid gastrointestinal (UMGI) capsule endoscopy using the modified detachable string magnetically controlled capsule endoscopy (DS-MCE) and inspection method and aimed to assess the clinical application.MethodsPatients were recruited to undergo UMGI capsule endoscopy followed by esophagogastroduodenoscopy. All capsule procedures in the upper gastrointestinal (UGI) tract were conducted under the control of magnet and string. The main outcome was technical success, and the secondary outcomes included visualization of the UMGI tract, examination time, diagnostic yield, compliance, and safety evaluation.ResultsThirty patients were enrolled and all UMGI capsule procedures realized repeated observation of the esophagus and duodenum with detection rates of 100.0%, 80.0%, and 86.7% of Z-line, duodenal papilla, and reverse side of pylorus, respectively. String detachment was succeeded in 29 patients (96.7%) and the complete examination rate of UMGI tract was 95.45% (21/22). All UMGI capsule procedures were well tolerated with low discomfort score, and had a good diagnostic yield with per-lesion sensitivity of 96.2% in UGI diseases. No adverse events occurred.ConclusionsThis new capsule endoscopy system provides an alternative screening modality for the UMGI tract, and might be indicated in cases of suspected upper and small bowel GI bleeding.Trial registration DS-MCE-UGI and SB, NCT04329468. Registered 27 March 2020, https://clinicaltrials.gov/ct2/results?cond=&term=NCT04329468.

P345 Capsule endoscopy in the diagnostic process of suspected Crohn's Disease

Abstract Background Since more than 20 years, capsule endoscopy (CE) complements endoscopic and radiological examinations, to diagnose diseases of the small bowel (SB), for it allows the direct visualisation of the intestinal mucosa. Although nearly 30% of people suffering from Crohn’s Disease (CD) are affected by an inflammation solely in the SB, this minimally invasive approach is mostly used late in the diagnostic algorithm. Studies concerning indicators of quality of the CE system exist above all for the indication of obscure gastrointestinal bleeding (OGIB), therefore, the aim of this study is to analyse the detection, completion, and complication rate as well as visibility and passage times of the CE in a cohort with suspected CD. Additionally, the different CE models should be compared regarding these parameters and an assessment, which influence the intraobserver-variability exercises on the diagnostic accuracy should be conducted. Methods For this purpose, corresponding data out of written CE records from 430 patients in a tertiary hospital in the eastern part of Austria were retrospectively analysed. “Major Lesions” contained aphthoid, ulcerating and stenosing pathologies whereas “Minor Lesions” consisted of mucosal and villous abnormalities. In addition, the diagnose made after a follow-up period of six months was extracted from the individual medical records. Results 52,8% of the examinations were performed using the CapsoCam system, altogether there was a detection rate of 35,1%, the most frequent detected lesions being aphthoid abnormalities (76,8%). There was a completion rate of 95,4% and an average passage time of 266,94 ± 121,11 minutes. In 1,2% of the cases, a capsule retention occurred with a 1696 times higher chance in the presence of a stenosis. The visibility was rated “good” in 72,6% and the comparison between CapsoCam, PillCam, MiroCam and EndoCapsule showed, that only the completion rate has been associated with the choice of the CE model. After six months, CD has been diagnosed within 26,5% of the patients, resulting in a sensitivity of 70,2%, a specificity of 81,5% and a negative predictive value (NPW) of 84,2%. Conclusion Bearing in mind the increasing global incidence of CD and the association between an isolated inflammation in the SB with a poorer prognosis, CE can be highly contributing to an early diagnosis. The method is minimally invasive, patient-friendly, with a low complication rate due to a selective patient evaluation for the indication of suspected CD and the technology is constantly developing. The lack of standardized diagnostic criteria may be an important limitation, especially regarding the diagnostic accuracy, but special endoscopic indices are coming more and more into effect.

5G-based remote magnetically controlled capsule endoscopy for examination of the stomach and small bowel.

Remote endoscopy can improve diagnostic efficiency of gastrointestinal (GI) diseases for patients in remote areas. A novel remote magnetically controlled capsule endoscopy (MCE) system based on a 5G network was developed for real-time remote GI examinations. We aimed to evaluate the feasibility and safety of the 5G-based remote MCE for examination of the stomach and small bowel. This was a prospective, nonrandomized, comparative study. Consecutive participants enrolled in the First People's Hospital of Yinchuan underwent remote MCE examinations performed by an endoscopist located in Changhai Hospital. Consecutive participants enrolled in Changhai Hospital underwent conventional MCE examinations performed by the same endoscopist. The main outcomes included the complete visualization rate of the stomach and small bowel, safety assessment and network latency time of remote MCE examinations. From March 2021 to June 2021, 20 participants in each group were enrolled. The complete visualization rate of the stomach and small bowel was 100% in both groups (p>0.999) without any adverse event. The median network latency time of remote MCE group was 19.948ms. Gastric examination time (8.96 vs. 8.92min, p=0.234), maneuverability (15.00 vs. 15.00, p=0.317), image quality (1.00 vs. 1.00, p>0.999) and diagnostic yields in the stomach and small bowel (55% vs. 30%, 5% vs. 0%, both p>0.05) were comparable between remote and conventional MCE groups. All participants in remote MCE group considered remote MCE acceptable and necessary. 5G-based remote MCE was a feasible and safe method for viewing the stomach and small bowel.

Localization of Passively Guided Capsule Endoscopes—A Review

Traditional endoscopy is conducted stationary in the hospital and requires sedation of the patient. Contrary, capsule endoscopy (CE) requires no sedation, and the patients are allowed to leave the hospital for their daily life during the procedure that lasts for several hours. Commercially available capsule endoscopes are passively moved through the gastrointestinal tract (GIT) by peristalsis. For diagnosis and intervention planning, the traveled distance and orientation of the capsules for each video frame would be highly relevant. Nevertheless, commercial capsule endoscope systems do not offer precise localization of the capsules. In the past years, many different scientific localization approaches have been proposed. These methods can be divided into video-, radio frequency-(RF), and magnetic field-based methods. In this review, a requirement profile for a localization method suitable for a commercial capsule endoscopy system is defined. The defined requirements of a localization system for capsule endoscopy are high accuracy, robustness during the daily life of a patient, and integrability with commercial capsule endoscopy systems. Afterward, promising approaches are reviewed and discussed concerning these requirements. It was revealed that the magnetic field- and video-based methods are the most promising methods, and these methods would complement each other very well. Therefore, a hybrid magnetic-field-/video-based method is suggested, which has, to the best of our knowledge, not been proposed so far.

Feasibility of Novel Magnetically Controlled Cable Capsule Endoscopy System In Vitro Experiments for Gastric Examination.

Background Magnetically controlled capsule endoscopy has been shown to be feasible for the examination of gastric diseases. However, there may be problems, such as low image quality, incomplete esophageal observation, and capsule retention. We developed a novel magnetically controlled cable capsule endoscopy (MCCCE) system and evaluated its feasibility through in vitro experiments. Methods Three experienced endoscopists performed MCCCE on the plastic stomach model and the excised porcine stomach model 5 times, respectively. Outcomes included handle ability, examination time, examination completion, and image quality. The examination completion was accessed by other two blinded endoscopists, and the image quality was compared with conventional gastroscopy (Olympus, GIF-290). Results The performance of MCCCE in vitro experiments is excellent, with a mean operation time of 18.5 minutes in the plastic stomach model and 17.3 minutes in the excised porcine stomach model. The visualization rate of the gastric mucosa is >90% in the plastic stomach model and 75–90% in the excised porcine stomach model. The images of MCCCE are very clear, with good color resolution and no image distortion, which seem to be comparable to conventional gastroscopy. Conclusions MCCCE system is feasible for gastric examination in vitro experiments, living animal experiments and human trials need to be further conducted.

In vitro and in vivo evaluation of a novel wired transmission magnetically controlled capsule endoscopy system for upper gastrointestinal examination.

Magnetically controlled capsule endoscopy (MCCE) has recently increasingly been used for gastric examination. However, the image quality and esophageal observation is suboptimal. We developed a novel wired transmission magnetically controlled capsule endoscopy (WT-MCCE) system and evaluated its feasibility through in vitro and in vivo experiments. A plastic stomach model and a pathological upper gastrointestinal model were used to evaluate the performance of WT-MCCE in vitro experiments. Twice of examination in the two in vitro models by WT-MCCE were performed by 5 endoscopists who were experienced in performing wireless capsule endoscopy. The examination of traditional gastroscopy (Olympus, GIF-HQ290) in the pathological upper gastrointestinal model was set as the control. In vivo experiments were performed in a live canine model by 3 endoscopists, in which WT-MCCE was inserted with the assistance of gastroscopy. Measurements included maneuverability, examination time, visualization of gastric mucosa, image quality and diagnostic accuracy. WT-MCCE showed good performance in both in vitro and in vivo experiments with excellent visualization of mucosa (75-100%). The mean operation time is 17.6 ± 2.7min, 22.3 ± 1.9min and 29.3 ± 3.4min in three models, respectively. In pathological upper gastrointestinal model, all lesions, including esophageal varices, one polyp, one foreign body, two gastric ulcers and one duodenal ulcer, were detected by both WT-MCCE and traditional gastroscopy by all endoscopists. For the observation of esophagus and stomach in the canine model, WT-MCCE also showed excellent maneuverability and good image quality. The novel WT-MCCE system performed well in evaluating upper gastrointestinal landmarks and lesions in two in vitro models, and showed good performance in a canine model. WT-MCCE may be potentially useful for diagnosis of esophageal and gastric diseases.

A Wideband Dual-Polarized Ring-Loaded Cross Bowtie Antenna for Wireless Capsule Endoscopes: Design and Link Analysis

This work presents a novel on- body wideband dual-polarized antenna to stabilize and enhance the link performance of wireless capsule endoscopy systems. By introducing a cross-bowtie structure with a planar compact feed method, the antenna achieves a dual-polarized performance with high port-to-port isolation. A loaded ring with additional stubs is also implemented to further enhance the bandwidth and provide a flat in-band performance from 381 to 990 MHz. The proposed antenna is measured with both homogeneous phantom and ex vivo test to validate the impedance matching performance. To validate the effectiveness of the proposed on- body antenna on the communication link, a capsule helical antenna with omnidirectional radiation pattern is designed and measured. Finally, comprehensive link studies are conducted considering the varied capsule orientations and locations, with a peak <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\vert S_{21}\vert $ </tex-math></inline-formula> value of–25.5 dB at the 60 mm implant depth and an acceptable link loss due to the capsule position error. The proposed on- body antenna can be regarded as a good candidate for a practical capsule endoscopy system due to its stable and enhanced transmission performance when compared with its counterparts.

Compacted conformal antenna at lower-UWB for wireless capsule endoscope system

Compacted conformal antenna at lower-UWB for wireless capsule endoscope system

Readjustment of Capsule Endoscopy Protocols to the COVID-19 Pandemic in a Portuguese Tertiary Center.

The prevention of severe acute respiratory syndrome corona virus 2 transmission implies several social distancing mea- sures, imposing a change in the protocols of several hospital departments. Capsule endoscopy protocols changes were implemented and evaluated in a Portuguese tertiary center. The authors compared pre-pandemic and peri-pandemic protocols, the latter favoring social distancing, used in MiroCam (IntroMedic, Seoul, Korea) and PillCam Crohn (Medtronic, Minneapolis, Minn, USA) capsule endoscopy, in a Gastroenterology Department of a tertiary center. All capsule endoscopy performed in outpatients between February 2018 and September 2020 was included. The authors compared significant lesions detection rate, completeness of procedure, adequate bowel preparation, complications rate, and patient satisfaction (through a brief phone call survey) among the protocols. This study included 70 MiroCam CE and 43 PillCam Crohn capsule endoscopy. No statistically significant differences concern- ing performance measures and patients satisfaction were found among the pre-pandemic protocol and the peri-pandemic protocol in MiroCam capsule endoscopy. Conversely, in PillCam Crohn capsule endoscopy, the rate of complete exams was significantly inferior in the peri-pandemic protocol (84.8% vs 50.0%, P = .036), with no other statistically significant differences in the remaining parameters. The performance measures and patient satisfaction were similar among the protocols analyzed for MiroCam capsule endoscopy. Thus, the readjustment of this capsule endoscopy system, which favors a reduction in hospital stay, appears to be a good alternative to the former protocols in this pandemic era. In contrast, the rate of complete exams was significantly inferior in the adapted protocol to the pandemic era for PillCam Crohn capsule endoscopy, disfavoring its maintenance in the clinical practice.