| Summary: | Capsule endoscopy was introduced in 2000 and has since become the investigative modality of choice for mucosal diseases of the small bowel. This innovative device, which comprises of imaging components encased within a pill-sized capsule, allows for non-invasive examination of the small bowel. The aim of this thesis is to evaluate advances in capsule endoscopy which have the potential to extend and improve the practice of this tool.
The first section of this thesis examines the impact of fatigue on the accuracy of small bowel capsule endoscopy interpretation. Capsule studies involve the presentation of many thousands of repetitive images, which are time-consuming to interpret. There is some evidence for the impact of fatigue in the detection of adenomas during colonoscopy. In comparison capsule interpretation is passive, has little visual variability, and may, therefore, have a greater potential to induce fatigue. Here we hope to establish if this does indeed occur and if so, whether it affects the quality of subsequent readings.
The second section investigates a potential solution to the numerous images presented. Omni-Mode is a novel rapid reading algorithm which proposes to remove similar images in order to reduce the images presented. By limiting the images to only those displaying unique information, accurate diagnosis could be made in a fraction of the time. This software was evaluated in a multi-centre European trial, where the diagnostic accuracy and reading times achieved with Omni-Mode were compared to conventional reading.
The final section of this thesis explores the use of capsule endoscopy outside of the small bowel by means of a modification to the capsule hardware. The addition of magnetic material within the capsule allows in-vivo manoeuvrability under the control of an external magnet. Here we explore the use of a Magnetically Assisted Capsule Endoscope as an alternative to conventional endoscopy, providing a non-invasive method for examination of the upper gastrointestinal tract. In this study, we have focussed on the detection of oesophageal pathology, which has the potential to be missed during the rapid oesophageal transit of a standard capsule endoscope.
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