Verbesserungen der Kapselendoskopie

Zusammenfassung

Die Videokapselendoskopie des Dünndarms hat seit ihrer Einführung vor 8 Jahren zahlreiche Verbesserungen erfahren. Zunächst wurde die Technik der Kapsel selbst optimiert mit längerer Funktionsdauer, Einbau einer Beleuchtungsautomatik, erweitertem Blickwinkel und höherer Auflösung. Eine Darmreinigung vor der Untersuchung und die Verwendung eines Entschäumers verbessert die Sicht. Die Auswertung konnte durch weiterentwickelte Software vereinfacht und beschleunigt werden. Etablierung von Kursen und Online-Hilfen sollen die Qualität der Befundung verbessern. Durch zahlreiche klinische Studien konnte die Indikationsstellung präzisiert werden und eine Einordnung der Kapselendoskopie in die Betreuung von Patienten mit Dünndarmerkrankungen erfolgen. Bei Patienten mit Schluckstörung kann die Kapsel endoskopisch platziert werden, eine Betrachtung der Bilder in Echtzeit ermöglicht das Erkennen einer Magenretention mit der Möglichkeit des zeitnahen endoskopischen Vorschubs. Die Doppelballon-Enteroskopie erlaubt es schließlich retinierte Kapseln wieder zu entfernen.

Abstract

Several improvements of video capsule endoscopy have been made since its introduction in 2000. Technical features of the capsule have been optimized like prolonged working time, implementation of illumination control, a wider field of view and a higher resolution. Usage of purgatives and anti-foaming agents improve visualization. Evaluation of the videos was simplified and shortened by improved software. Courses and online aids have been established to increase the quality of diagnoses. Results of numerous studies help to make indications for video capsule endoscopy more precise and to implement the method sensefully into the management of patients with small intestinal diseases. Capsules can be placed endoscopically in patients with swallowing disorders. Real time viewing allows detection of gastric retention and consecutive endoscopic transport. Finally, double balloon enteroscopy provides the possibility to extract retained capsules.

Schlüsselwörter

Videokapselendoskopie - Dünndarm - Technik - Befundung - Vorbereitung

Key words

video capsule endoscopy - small intestine - technique - reporting - preparation

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