Capsule endoscopy: Do we still need it after 24 years of clinical use?

Abstract

In this letter, we comment on a recent article published in the World Journal of Gastroenterology by Xiao et al, where the authors aimed to use a deep learning model to automatically detect gastrointestinal lesions during capsule endoscopy (CE). CE was first presented in 2000 and was approved by the Food and Drug Administration in 2001. The indications of CE overlap with those of regular diagnostic endoscopy. However, in clinical practice, CE is usually used to detect lesions in areas inaccessible to standard endoscopies or in cases of bleeding that might be missed during conventional endoscopy. Since the emergence of CE, many physiological and technical challenges have been faced and addressed. In this letter, we summarize the current challenges and briefly mention the proposed methods to overcome these challenges to answer a central question: Do we still need CE?

Keywords: Capsule endoscopy; Wireless capsule endoscopy; Obscure gastrointestinal bleeding; Artificial intelligence in gastroenterology; Therapeutic capsule endoscopy

Core Tip: In this letter, we comment on a recent article published in the World Journal of Gastroenterology by Xiao et al, wherein the authors explored the use of a deep learning model to automatically detect gastrointestinal lesions during capsule endoscopy. We conclude that while capsule endoscopy remains a valuable tool in clinical practice, it carries many challenges that discourage its routine use. These challenges must be addressed in future studies to enhance its practicality and adoption by gastroenterologists.