Endoscopic capsule endoscope delivery for patients with dysphagia, anatomical abnormalities, or gastroparesis

Background: Capsule endoscopy relies on an intact swallowing mechanism and unimpeded passage of the capsule through the pylorus. A technique is described for endoscopic delivery of the capsule in patients with dysphagia, anatomical abnormality, or gastroparesis. Methods: EGD is performed with concomitant placement of an overtube. A foreign body net retrieval device is passed through the endoscope and used to grasp the activated capsule in the net. The endoscope then is advanced through the overtube, and the capsule is released in the duodenum. Observations: Five patients underwent endoscopic placement of the capsule. Relative contraindications to peroral ingestion were the following: oropharyngeal dysphagia, pyloric stenosis (2), prior gastric surgery, and gastroparesis. Endoscopic delivery was successful in all cases and yielded positive findings in 4. There was no complication. Conclusions: Endoscopic delivery of the capsule endoscope for patients with dysphagia, anatomical abnormality, or gastroparesis is safe and effective.