Gettman Matthew T, Swain Paul
Department of Urology, Mayo Clinic, Rochester, MN 55905, USA.
Eur Urol. 2009 May;55(5):1207-12. doi: 10.1016/j.eururo.2009.01.047. Epub 2009 Feb 4.
Cystoscopy remains one of the most important diagnostic procedures for the lower urinary tract. Wireless capsule endoscopy was introduced in the 1990s but use to date is limited to gastroenterology.
We evaluated the feasibility in the pig model of using wireless capsule endoscopes (WCEs) for cystoscopy.
DESIGN, SETTING, AND PARTICIPANTS: Experimental evaluation of capsule cystoscopy was performed in a 50-kg farm pig. The capsule was deployed into the bladder through a custom access sheath. Images were continuously transmitted at a rate of four frames per second to a laptop computer and processed using proprietary software. Manipulation of the WCE within the bladder was performed using a set protocol. The animal was then euthanized and gross inspection was performed.
We measured the ability to deploy and manipulate the capsule within the bladder. Feasibility of capturing and retrieving images in real time was also assessed.
The WCE was efficiently deployed and manipulated within the bladder passively and with the use of external magnets. The entire bladder mucosa was visualized. Real-time image transmission and capture were successful. No complications were seen during capsule cystoscopy. Minor urethral bleeding was observed after the experiment, likely related to placement of the access sheath required for deployment of the WCE. Limitations are that the evaluation of WCE was performed in the pig model, in only one female animal, using a nonsurvival approach. Furthermore, the study was not designed to differentiate normal from abnormal mucosal findings and focused solely on inspection of the bladder.
This report suggests that cystoscopy with a WCE is feasible. With this device, all aspects of the bladder mucosa could be visualized, and ongoing technologic and procedural developments are warranted for this new approach.
膀胱镜检查仍是下尿路最重要的诊断方法之一。无线胶囊内镜于20世纪90年代问世，但迄今为止仅用于胃肠病学领域。
我们评估了在猪模型中使用无线胶囊内镜（WCE）进行膀胱镜检查的可行性。
设计、场所和参与者：在一头50千克的农场猪身上对胶囊膀胱镜进行了实验评估。通过定制的接入鞘将胶囊部署到膀胱中。图像以每秒四帧的速率连续传输到笔记本电脑，并使用专有软件进行处理。使用既定方案在膀胱内操作WCE。然后对动物实施安乐死并进行大体检查。
我们测量了在膀胱内部署和操作胶囊的能力。还评估了实时捕获和检索图像的可行性。
WCE在膀胱内通过被动方式以及使用外部磁铁有效地进行了部署和操作。整个膀胱黏膜都能被看到。实时图像传输和捕获成功。在胶囊膀胱镜检查期间未观察到并发症。实验后观察到轻微尿道出血，可能与部署WCE所需的接入鞘放置有关。局限性在于对WCE的评估是在猪模型中、仅在一只雌性动物身上、采用非存活方法进行的。此外，该研究并非旨在区分正常与异常的黏膜表现，仅专注于膀胱检查。
本报告表明使用WCE进行膀胱镜检查是可行的。使用该设备，可以看到膀胱黏膜的各个方面，这种新方法在技术和操作方面的持续发展是有必要的。
