Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2016; 22(1): 369-378
Published online Jan 7, 2016. doi: 10.3748/wjg.v22.i1.369
Capsule endoscopy: The road ahead
Ana-Maria Singeap, Carol Stanciu, Anca Trifan
Ana-Maria Singeap, Anca Trifan, Gastroenterology and Hepatology Institute, “Gr. T. Popa” University of Medicine and Pharmacy, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
Carol Stanciu, Gastroenterology and Hepatology Institute, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
Author contributions: Singeap AM, Stanciu C and Trifan A contributed equally to the conception and design of the review; Singeap AM performed acquisition of data; Stanciu C analyzed the data, coordinated the manuscript drafting and revised it critically; Trifan A participated in the analysis and interpretation of data, and critically revised the manuscript for important intellectual content; all authors read and approved the final version of the manuscript.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Carol Stanciu, MD, FRCP, Professor, Gastroenterology and Hepatology Institute, “St. Spiridon” Emergency Hospital, Independentei 1, 700111 Iasi, Romania. stanciucarol@yahoo.com
Telephone: +40-732-402860 Fax: +40-232-246611
Received: May 5, 2015
Peer-review started: May 9, 2015
First decision: July 19, 2015
Revised: August 4, 2015
Accepted: September 30, 2015
Article in press: September 30, 2015
Published online: January 7, 2016
Processing time: 240 Days and 12.6 Hours
Abstract

Since its introduction into clinical practice 15 years ago, capsule endoscopy (CE) has become the first-line investigation procedure in some small bowel pathologies, and more recently, dedicated esophageal and colon CE have expanded the fields of application to include the upper and lower gastrointestinal disorders. During this time, CE has become increasingly popular among gastroenterologists, with more than 2 million capsule examinations performed worldwide, and nearly 3000 PubMed-listed studies on its different aspects published. This huge interest in CE may be explained by its non-invasive nature, patient comfort, safety, and access to anatomical regions unattainable via conventional endoscopy. However, CE has several limitations which impede its wider clinical applications, including the lack of therapeutic capabilities, inability to obtain biopsies and control its locomotion. Several research groups are currently working to overcome these limitations, while novel devices able to control capsule movement, obtain high quality images, insufflate the gut lumen, perform chromoendoscopy, biopsy of suspect lesions, or even deliver targeted drugs directly to specific sites are under development. Overlooking current limitations, especially as some of them have already been successfully surmounted, and based on the tremendous progress in technology, it is expected that, by the end of next 15 years, CE able to perform both diagnostic and therapeutic procedures will remain the major form of digestive endoscopy. This review summarizes the literature that prognosticates about the future developments of CE.

Keywords: Capsule endoscopy; Biopsy; Drug delivery systems; Capsule endoscope locomotion; Capsule localization

Core tip: Since its introduction into clinical practice 15 years ago, small bowel capsule endoscopy (CE) has revolutionized direct endoscopic imaging of the gut. During this time, CE has gained tremendous popularity among gastroenterologists, and a vast research pertaining to its different aspects has been published. Dedicated esophageal and colon CE have expanded the field of application to upper and lower gastrointestinal disorders. However, besides its recognized advantages, CE also has several limitations such as the lack of therapeutic capabilities, the inability to obtain biopsies and control its locomotion. Active research is in progress to overcome the current limitations, while the latest advances in CE technology enable us to look forward to a next generation CE capable of performing both diagnostic and therapeutic procedures. This review summarizes the literature that prognosticates about the future of CE.