Evaluation of the small bowel and colon

Abstract

Currently available endoscopic technologies for small bowel and colon evaluation include traditional endoscopic techniques, deep enteroscopy techniques, and wireless video capsule endoscopy. Wireless video endoscopy can roughly be defined as the use of means other than directly controlled, applied, or introduced electrical devices to obtain imaging data from the gastrointestinal tract to provide a diagnostic and/or treatment modality for a disease. In the world of science fiction, we imagine the ability to diagnose disease via a noninvasive "tricorder" like device (Star Trek, circa 1960s), and then perhaps employ nanotechnology targeted to the abnormality to treat it (Star Trek, circa 1990s). An analogy to this is the development of wireless video surveillance and weapons systems, some of which can be remotely guided for use by law enforcement and the military. A tremendous amount of resources for research and development is required to develop this type of remote wireless technology, which is also still highly dependent on operator training and experience to be effective. In this chapter, we review existing wireless video technologies currently in use in diagnosing and treating gastrointestinal diseases of the small bowel and colon, and those modifications that are currently in the development and planning stages. We also review the means of wireless physiologic assessment of the small bowel (SmartPill) and current and potential future applications of more traditional "wired" endoscopic technologies, including single balloon enteroscopy, double balloon enteroscopy, spiral enteroscopy, and NaviAid.