Wireless Video Capsule Enteroscopy in Preclinical

Authors: Marcela Kopáčová Ilja Tachecí Jaroslav Květina Jan Bureš Martin Kuneš Stanislav Špelda Věra Tyčová Zbyněk Svoboda Stanislav Rejchrt

Publish Date: 2009/03/18

Volume: 55, Issue: 3, Pages: 626-630

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Abstract

The aim of this project was to develop a methodology to introduce wireless video capsule endoscopy in preclinical research Five mature female pigs Sus scrofa domestica were selected for the study Capsule endoscopes the EndoCapsule system Olympus were introduced into the duodenum endoscopically in each of the animals The life span of batteries ie total time of endoscopy recording was 487–540 min median 492 min The capsule endoscope reached the cecum during enteroscopy once after 7 h 57 min in the remaining cases endoscopy recordings terminated in the distal or terminal ileum All capsule enteroscopies found a normal pattern of the small intestine The intestinal lumen is narrower transverse folds are sparse or even absent villi are wider but less prominent in pigs compared to humans Capsule endoscopy in experimental pigs will be helpful for future trials on injury of different drugs and xenobiotics to the small bowelWireless video capsule endoscopy represents fundamental progress in noninvasive imaging of the gastrointestinal tract particularly the small bowel The method was introduced into clinical practice in 2001 and more than 500000 examinations have been performed in humans worldwide up to the present time 1 2 3 4 5 At a very early stage an initial study on experimental use of capsule endoscopy in dogs was published 6 However other papers dealing with the use of capsule endoscopy in a different experimental setting are still missing The aim of this project was to develop a methodology to introduce wireless video capsule endoscopy in experimental pigs The small adult pig can be used in experiments as an omnivorous representative due to its relatively very similar gastrointestinal functions in comparison to humans 7In a pilot test on experimental pigs we proved that endoscopic insertion of video capsules into the duodenum is feasible A transverse semi ballshaped pyloric fold torus pyloricus was found in the porcine stomach of all animals serving as a “gatekeeper” and thus making the endoscopic insertion technically difficult The position of capsule endoscopes was set in three animals in the proximal jejunum 330 cm after 90 min in the proximal ileum after 180 min and in the cecum after 9 h In another four animals the time until natural excretion of capsule endoscopes in the feces was measured this was 72 48 40 and 65 h mean 56 ± 15 h The length of the small intestine of 4monthold pigs was found to be highly variable This was measured at immediate autopsy in 13 animals ranging from 112 to 168 m mean 134 ± 18 mFive mature female pigs Sus scrofa f domestica hybrids of Czech White and Landrace breeds weighing 366 ± 30 kg 4–5 months old were entered into the study An EndoCapsule system Olympus Optical Co Tokyo Japan was used for video capsule enteroscopies in all animals The wireless capsule endoscope has an outer diameter of 11 mm length of 26 mm and weighing 38 g Capsule endoscopes were introduced into the duodenum endoscopically in all animals Endoscopy procedures were performed using videogastroscopes GIFQ130 Olympus Optical Co Tokyo Japan dedicated for animal use only All endoscopies were recorded on DVD Four capsule endoscopes were placed into the duodenum by means of a G25 retrieval basket Sun Vikýřovice Czech Republic and the remaining one using the AdvanCE delivery system US Endoscopy Mentor USAData obtained during capsule enteroscopy were downloaded from the recorder unit to the workstation It contains proprietary application software “Endo Capsule Software” Olympus Optical Co Tokyo Japan which enables the smooth management of capsule endoscope examination data All video images were evaluated by a single physician using usually auto speed adjustment the review speed is automatically increased when there is little movement in consecutive images with the lower limit for 12frames/s of review speed in most recordingsThe next morning the pigs were sacrificed by means of pharmacological euthanasia T61 Intervet International BV Boxmeer the Netherlands dose of 2 ml/kg Immediate autopsy was performed and samples collected of the pyloric transverse fold and specimens of gastric and intestinal segments for light microscopyThe project was approved by the Institutional Review Board of the Animal Care Committee at the Institute of Experimental Biopharmaceutics Academy of Sciences of the Czech Republic Protocol Number 149/2006 Animals were held and treated in accordance with the European Convention for the Protection of Vertebrate Animals Used for Experimental and Other Scientific Purposes 8

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