21 research outputs found
Bouveret syndrome in a cholecystoduodenal fistula
The treatment of Bouveret syndrome lacks specific guidelines and is strictly interdisciplinary.
Especially, if electrohydraulic lithotripsy is not available and endoscopic
removal fails, a timely surgical approach is advised
A. Training Simulators for Gastrointestinal Endoscopy: Current and Future Perspectives
Over the last decades, visual endoscopy has become a gold standard for the detection and treatment of gastrointestinal cancers. However, mastering endoscopic procedures is complex and requires long hours of practice. In this context, simulation-based training represents a valuable opportunity for acquiring technical and cognitive skills, suiting the different traineesâ learning pace and limiting the risks for the patients. In this regard, the present contribution aims to present a critical and comprehensive review of the current technology for gastrointestinal (GI) endoscopy training, including both commercial products and platforms at a research stage. Not limited to it, the recent revolution played by the technological advancements in the fields of robotics, artificial intelligence, virtual/augmented reality, and computational tools on simulation-based learning is documented and discussed. Finally, considerations on the future trend of this application field are drawn, highlighting the impact of the most recent pandemic and the current demographic trends
Inter/intra-observer agreement in video-capsule endoscopy : are we getting it all wrong? A systematic review and meta-analysis
Video-capsule endoscopy (VCE) reading is a time- and energy-consuming task. Agreement
on findings between readers (either different or the same) is a crucial point for increasing performance
and providing valid reports. The aim of this systematic review with meta-analysis is to provide
an evaluation of inter/intra-observer agreement in VCE reading. A systematic literature search in
PubMed, Embase and Web of Science was performed throughout September 2022. The degree of
observer agreement, expressed with different test statistics, was extracted. As different statistics are
not directly comparable, our analyses were stratified by type of test statistics, dividing them in groups
of âNone/Poor/Minimalâ, âModerate/Weak/Fairâ, âGood/Excellent/Strongâ and âPerfect/Almost
perfectâ to report the proportions of each. In total, 60 studies were included in the analysis, with
a total of 579 comparisons. The quality of included studies, assessed with the MINORS score, was
sufficient in 52/60 studies. The most common test statistics were the Kappa statistics for categorical
outcomes (424 comparisons) and the intra-class correlation coefficient (ICC) for continuous outcomes
(73 comparisons). In the overall comparison of inter-observer agreement, only 23% were evaluated as
âgoodâ or âperfectâ; for intra-observer agreement, this was the case in 36%. Sources of heterogeneity
(high, I2 81.8â98.1%) were investigated with meta-regressions, showing a possible role of country,
capsule type and year of publication in Kappa inter-observer agreement. VCE reading suffers from
substantial heterogeneity and sub-optimal agreement in both inter- and intra-observer evaluation.
Artificial-intelligence-based tools and the adoption of a unified terminology may progressively
enhance levels of agreement in VCE reading.peer-reviewe
An overview of the evolution of capsule endoscopy research â text-mining analysis and publication trends
There has been a steady increase (annual percentage growth rate of 19.2%, average of 18.3 citations per document) in capsule endoscopy (CE) publications from a global, interdisciplinary research community on a growing range of CE applications over the last 20+ years. We here present the status of CE as a field of research, tracing its evolution over time and providing insight into its potential for diagnostics, prevention and treatment of gastrointestinal (GI) tract diseases. To portray the development of the CE research landscape in the 2000â2021 time span, we analyzed 5764 scientific publications. Analyses were performed using the R language and environment for statistical computing and graphics and VOSviewer, a software developed for scientific literature analysis by scientometricians. The aim of this paper is to provide a wide comprehensive analysis of the trends in CE publications. We thus performed subgroup analysis on the selected papers, including indications, annual percentage growth rate, average citations per document, most publications from research areas/interdisciplinary field of the articles, geography, collaboration networks through institutions, specific clinical keywords and device type. The firm increase in CE publications over the last two decades highlights the overall strength of the technology in GI applications. Furthermore, the introduction to the field of artificial intelligence (AI) tools has been promoting a range of technological advances that keep on affecting the diagnostic potential of CE
An overview of robotic capsules for drug delivery to the gastrointestinal tract
The introduction of capsule endoscopy two decades ago marked the beginning of the âsmall bowel revolutionâ. Since then, the rapid evolution of microtechnology has allowed the development of drug delivery systems (DDS) designed to address some of the needs that are not met by standard drug delivery. To overcome the complex anatomy and physiology of the gastrointestinal (GI) tract, several DDS have been developed, including many prototypes being designed, built and eventually produced with ingenious drugârelease mechanisms and anchoring systems allowing targeted therapy. This review highlights the currently available systems for drug delivery in the GI tract and discusses the needs, limitations, and future considerations of these technologies