カプセル内視鏡の挿入補助:嚥下困難，食道・胃停滞例への対応

Small bowel capsule endoscopes have been developed as a first-line tool for exploring the entire small bowel. The patency capsule is a tag-less capsule used to evaluate gastrointestinal patency prior to small bowel capsule endoscopy. Colon capsule endoscopy has been shown to be an alternative to conventional colonoscopy as well as CT colonography in cases in which a previous colonoscopy was incomplete, or for patients who are unsuitable to undergo colonoscopy. However, ingestion of these capsules is sometimes difficult for young children and even adults with dysphagia because of foreign bodies measuring as large as 11 × 26-31 mm. Even if ingested, they can lodge in the esophagus or stomach for long durations. In such cases, endoscopic capsule placement is available using the AdvanCE-J delivery device, polypectomy snares, nets, etc. Endoscopic deployment of capsule endoscopes has been reimbursed for patients younger than 15 years of age in Japan since April 2022. Here, we demonstrate the devices, technical procedures, and indications of endoscopic deployment of capsule endoscopes based on the findings of the AdvanCE-J study (Safety and Efficacy of the Endoscopic Delivery of Capsule Endoscopes in Adult and Pediatric Patients: A Multicenter Japanese Study).