Chapter 5 Capsule Endoscope Procedures Inserting battery pack into real time viewer 1. Open the battery pack slot cover by sliding it in the direction of the arrow (see Figure 5.23 (b)). Arrow ( ) (a) (b) Figure 5.23 2. With the battery pack removal ribbon hanging out of the battery pack slot, insert a fully charged battery pack into the slot (see Figure 5.24 (b)). Battery pack Figure 5.24 3.
Chapter 5 Capsule Endoscope Procedures 5.6 Attaching the equipment to the patient Patient confirmation Before attaching the antenna lead set to the patient, confirm the patient’s identity. Also confirm that the patient has not eaten or drunk for at least 8 hours before the examination. Confirmation of antenna locations (and shaving, if necessary) 1. Ask the patient to lie down with his upper body exposed, and to lower his pants or skirt. 2.
Chapter 5 Capsule Endoscope Procedures Pink: Around the epigastric (center of body) Red: 7th right rib (immediately below the chest bulge) Brown: 7th left rib (immediately below the chest bulge) Yellow: Above the umbilicus (not to overlap the umbilicus) Green: Right flank White: Left flank Blue: Right lower abdomen (lowest possible position unaffected by bending of thigh) Purple: Left lower abdomen (lowest possible position unaffected by bending of thigh) For patients of large stature Figure 5.
Chapter 5 Capsule Endoscope Procedures Attaching the antenna lead cover Before attaching the antenna lead cover to the antenna pad, check that the antenna pad has not been folded or creased, and that the antenna cable is free of significant deformation or abnormalities. 1. Insert the antenna into the antenna lead cover so that its color tag is on the same side as the blue surface of the antenna lead cover, then align their holes (see Figure 5.28).
Chapter 5 Capsule Endoscope Procedures 2. Align the hole on the center of the antenna pad to the hole on the center of the antenna lead cover. Peel off the lining paper from the inside of the antenna lead cover (on the blue side), and adhere the antenna pad securely to the antenna lead cover (see Figure 5.29). Align the hole on the antenna pad with the hole on the antenna lead cover Attachment complete Figure 5.
Chapter 5 Capsule Endoscope Procedures Attaching the antennas to the patient Make sure that the antenna pads are attached firmly to the antenna lead cover, and that the antenna lead cover are attached firmly to the patient. Otherwise, noise may appear in the images, or the images may not be transmitted properly. 1. 2. Dry the patient’s body by wiping with a dry piece of gauze. Place the antenna pads on the patient so that their numbering matches the Antenna Locations Guide (see Figure 5.26).
Chapter 5 Capsule Endoscope Procedures 4. • Be sure to use the antenna covers when attaching the antennas. Failure to do so may prevent the proper reception of small bowel capsule endoscopic images. • Perform the examination with all 8 antenna pads attached to the patient. The examination may fail with even one antenna pad not properly attached. • Do not allow the antenna cable to lay on or near the antenna pads. It may prevent the proper reception of capsule endoscopic images.
Chapter 5 Capsule Endoscope Procedures 5. Have the patient wear the suspender. Figure 5.32 122 • The suspender can be released on one of its ends. • Pass the loose end of the belt between the belt and the pouch to keep it out of the way.
Chapter 5 Capsule Endoscope Procedures Connecting and testing the recorder unit and the antenna lead set 1. Connect the antenna lead set to the recorder unit by inserting the connection unit into the recorder unit until they click (see Figure 5.33). Figure 5.33 2. Hold down the recorder unit’s power switch for at least 1 seconds to turn ON the recorder unit. Figure 5.34 3. The Olympus logo is displayed again, and the indicator lamp illuminates in yellow for 2 seconds.
Chapter 5 Capsule Endoscope Procedures 4. The following information display screen (see Figure 5.35) is displayed on the recorder unit’s display panel, and the indicator lamp illuminates in green. Patient ID display Battery pack level indicator Figure 5.35 • If the indicator on the battery pack changes from to prior to the examination, recharge the battery pack, or replace with a fully-charged battery pack.
Chapter 5 Capsule Endoscope Procedures 5. Check that the recorder unit is displaying information for the patient that is about to be examined. 6. Insert the recorder unit into the recorder unit pouch, with its display panel facing outward (see Figure 5.37). Figure 5.37 7. To secure the recorder unit to the porch, close the pouch cover with the antenna cable passed through its side (or its center), then fasten the pouch cover with the Velcro straps (see Figure 5.38).
Chapter 5 Capsule Endoscope Procedures 8. • Ask the patient to adjust the position of the pouch when sitting down. • Show the patient how to loosen the recorder unit harness, for example, when using the bathroom. • The procedure for storing the recorder unit into the pouch is illustrated on the back side of the pouch cover. Have the patient connect the buckle, and then pass the antenna lead set through from the inside to the outside of the belt. Figure 5.
Chapter 5 Capsule Endoscope Procedures 9. Remove the rubber caps from the real time viewer cable connectors on the recorder unit (accessible via the opening on the lower right side of the netted pocket) and on the real time viewer. Using the real time viewer cable, connect the real time viewer to the recorder unit, as shown in Figure 5.40. Figure 5.
Chapter 5 Capsule Endoscope Procedures 11. The real time viewer’s display panel will display an icon ( ) indicating the connection to the recorder unit, and the octagonal display will show “No RECORD”. Recorder unit connection icon Figure 5.41 • When signals from the capsule endoscope are not being received, or if the reception is poor, “NO RECORD” will be displayed to the left of the octagonal display, and endoscope images cannot be recorder by the recorder unit.
Chapter 5 Capsule Endoscope Procedures 5.7 Preparing the capsule endoscope Do not use a capsule endoscope that have been dropped, bitten or been subjected to excessive pressure. Using such a capsule endoscope may result in infection of patient and/or medical personnel, as well as internal injury to the patient due to equipment damage. • If the sterile container is open or damaged, the sterility of the capsule endoscope may have been compromised. Use a new capsule endoscope instead.
Chapter 5 Capsule Endoscope Procedures Turning power ON 1. Slowly remove the sealing paper and take care that the capsule endoscope does not fall out of the container. Figure 5.43 2. Hold the sterile container, taking care not to squeeze it. Adjust the direction of the boss of the capsule activator to the closest groove to the handle of the inner lid of sterile container. Then insert the capsule activator straight along with the groove, the capsule endoscope turn ON (see Figure 5.44).
Chapter 5 Capsule Endoscope Procedures • The capsule activator is not sterilized. Do not allow the capsule endoscope to touch the activator. • Keep the capsule endoscope away from magnets. Magnets can turn the capsule endoscope ON, resulting in the consumption of battery power. • Do not look directly at the capsule endoscope’s LED for a prolonged duration. It may cause an afterimage. Inserting the capsule activator again will turn the capsule endoscope OFF.
Chapter 5 Capsule Endoscope Procedures 5.8 Starting the examination Instruct the patient to follow the cautions for Capsule Endoscopy Patients in the Capsule Endoscope Set A. Also instruct the patient to return to the hospital 8 hours after the beginning of the examination. Dispensing Do not use a capsule endoscope that has been dropped, bitten or subjected to excessive pressure. Using such endoscopes may result in internal injury to the patient due to equipment damage.
Chapter 5 Capsule Endoscope Procedures 5.9 During the examination Familiarize the patient with the following dangers, warnings and cautions. The capsule endoscope contains metal parts. While the capsule endoscope is in your body, stay away from equipment (i.e. MRI equipment) for which wearing of metallic objects is prohibited. Immediately consult a physician if abdominal pain, discomfort, or nausea is experienced after the patient ingests the capsule endoscope.
Chapter 5 Capsule Endoscope Procedures 5.10 Ending the examination Removing equipment 1. 8 hours after the start of the examination, check that the recorder unit’s indicator lamp has stopped blinking, and end the examination. If the indicator lamp is blinking, connect the real time viewer and determine whether to continue or stop the examination. 2. Take the recorder unit out of the storage pouch. Figure 5.
Chapter 5 Capsule Endoscope Procedures 3. Hold down the recorder unit’s power switch for 2 seconds or more to turn OFF the recorder unit, then disconnect the antenna lead set. Slide the antenna lead set eject button on the backside of the recorder unit, and disconnect the connection unit by sliding it in the direction of the arrow (see Figure 5.47). Pull the battery pack removal ribbon to remove the battery pack (see Figure 5.48). Recharge the battery. Figure 5.46 Figure 5.47 Figure 5.
Chapter 5 Capsule Endoscope Procedures 4. Remove the recorder unit harness from the patient. 5. Remove the antenna pads from the antenna lead cover. The antenna lead cover can be easily removed by holding the tab and tearing the center section of the blue surface, down along the perforation (see Figure 5.49). 6. Carefully remove the antenna lead cover from the patient. The antenna lead cover are single-use only. Do not reuse them.
Chapter 5 Capsule Endoscope Procedures Downloading image data The “Download” function is not available in Endo Capsule Software Light. Download the image data from the recorder unit to the workstation according to the following procedure: 1. • While downloading, do not remove the recorder unit from the cradle or turn OFF the workstation. Doing so may result in loss of image data. • While downloading, do not unplug the recorder unit cradle’s power supply cable.
Chapter 5 Capsule Endoscope Procedures 3. Remove the battery pack from the recorder unit and insert the recorder unit into the recorder unit cradle. The recorder unit will be turned ON automatically. 4. The patient’s ID and name are displayed on the recorder unit’s display panel (see Figure 5.50). Figure 5.50 If an error is detected on the recorder unit, the indicator lamp will blink yellow. To troubleshoot, refer to Chapter 8, “Troubleshooting” on page 233. 5.
Chapter 5 Capsule Endoscope Procedures 6. Click the [Download] button on the recorder management screen. The download screen is displayed (see Figure 5.52). Download button Figure 5.52 7. Information stored on the recorder unit is displayed on the download screen (see Figure 5.53). Figure 5.53 If two recorder units are connected, the information for both units is displayed.
Chapter 5 Capsule Endoscope Procedures 8. Check the checkbox for the recorder unit from which information is to be downloaded (see Figure 5.54). Checkbox for the recorder unit Figure 5.54 If the “Shutdown workstation” checkbox is checked, the workstation will be turned OFF after the download is completed (see Figure 5.55). Checkbox for Shutdown workstation Figure 5.
Chapter 5 Capsule Endoscope Procedures 9. Click the [Start] button. The image data download will start (see Figure 5.56). The download status is displayed after starting the download. Start button Figure 5.56 • If you click the [Cancel] button during the download, the download will stop immediately. As it is not possible to continue a stopped download process, you will be required to start the downloading from the beginning again.
Chapter 5 Capsule Endoscope Procedures 10. When the download has completed successfully, “Complete” is displayed on the download screen (see Figure 5.58). Figure 5.58 11. Click the [Close] button to exit the download screen. The recorder management screen is displayed (see Figure 5.59). Close button Figure 5.59 The workstation has disk space for about 30 examinations (Each examination is estimated to be 8 hours long). If you take many pictures and movies, the number of examination may decrease.
Chapter 5 Capsule Endoscope Procedures Removing the recorder unit The “Removing the Recorder Unit” function is not available in Endo Capsule Software Light. 1. On the recorder management screen, select the recorder unit you wish to remove (see Figure 5.60). The recorder unit Figure 5.60 2. Click the [Disconnect] button (see Figure 5.61). The selected recorder unit is turned OFF. Disconnect button Figure 5.61 3. Remove the recorder unit from the recorder unit cradle.
Chapter 5 Capsule Endoscope Procedures Confirming excretion of the capsule endoscope Familiarize the patient with the following “Caution for Capsule Endoscopy Patients”. The capsule endoscope contains metal parts. Instruct the patient to stay away from equipment (i.e. MRI equipment) for which wearing of metallic objects is prohibited while the capsule endoscope is in the patient’s body.
Chapter 6 Capsule Endoscope Image Observation Chapter 6 Capsule Endoscope Image Observation Images captured by the capsule endoscope are downloaded from the recorder unit to the workstation for viewing. • After viewing the images, prepare a back up onto a DVD to protect them from a hard disk failure. • Do not change the file structure in the workstation. The files may become inaccessible.
Chapter 6 Capsule Endoscope Image Observation 6.1 Main screen nomenclature and functions 4. Recorder button 5. Image display area 6. Log off button 3. List button 2. Report button 1. Export button Figure 6.1 1. Export button Displays the data export screen. 2. Report button Displays the report screen. 3. List button Displays the examination list screen. 4. Recorder button Displays the recorder management screen. 5. Image display area Displays the image data. 6.
Chapter 6 Capsule Endoscope Image Observation 6.2 Opening data If multiple capsules are included within examination data, the following warning message is displayed (see Figure 6.2). Check the previous and next thumbnails of “ ” mark on the time bar, and select an appropriate image to observe. Figure 6.
Chapter 6 Capsule Endoscope Image Observation • If the examination data is password-protected, the password input screen is displayed (see Figure 6.3). Enter the password for the examination data and click the [OK] button. • When you open new examination data while another examination data is already open, the previous examination data is closed to allow the new examination data to open. If the thumbnail data is not saved, you will be asked if you wish to save the data. Figure 6.
Chapter 6 Capsule Endoscope Image Observation Select “Open examination” or “Open thumbnails” from the “File” menu on the main screen. The examination list screen is displayed. 2. On the examination list screen, use the drive selection box to select the drive on which the examination data is stored (see Figure 6.5). Drive selection box Figure 6.5 To select examinations stored on the workstation, select workstation in the drive selection box. 3.
Chapter 6 Capsule Endoscope Image Observation 4. Select a thumbnail data, and click the [OK] button (see Figure 6.7). The main screen is displayed, and the examination data and thumbnail data are opened. OK button Figure 6.7 To create a new thumbnail data, select “New” (top row) from the examination data list, and click the [OK] button (see Figure 6.8). “New” OK button Figure 6.
Chapter 6 Capsule Endoscope Image Observation Opening data in Endo Capsule software light Opening examination data from the menu 1. Select “Open examination” from the “File” menu on the main screen (see Figure 6.9). The file open screen is displayed. Open examination Figure 6.9 2. Select the folder in which the examination data is saved (see Figure 6.10). Folder Figure 6.
Chapter 6 Capsule Endoscope Image Observation 3. Select the examination data (∗∗∗.opg), and click the [Open] button (see Figure 6.11). The examination data is opened. Open button Figure 6.11 Opening thumbnail data from the menu 1. Select “Open thumbnails” from the “File” menu on the main screen (see Figure 6.12). The file open screen is displayed. Open thumbnails Figure 6.
Chapter 6 Capsule Endoscope Image Observation 2. Select the folder in which the thumbnail data is saved (see Figure 6.13). Folder Figure 6.13 3. Select the thumbnail data (∗∗∗.xml), and click the [Open] button (see Figure 6.14). The thumbnail data is opened. Open button Figure 6.
Chapter 6 Capsule Endoscope Image Observation If you open an examination data and a thumbnail data for different examinations, the following error message will be displayed. Select the thumbnail data for the same examination, or create new thumbnail data. Figure 6.
Chapter 6 Capsule Endoscope Image Observation 6.3 Image observation Playing back images To play back the image data, use the buttons in the image operation area (see Figure 6.16). The image data being played back is displayed in the image display area. 4. Pause button 3. Reverse Playback button 5. Playback button 2. Previous Image button 6. Next Image button 1. First Image button 7. Last Image button Figure 6.16 1. First Image button Displays the first image. 2.
Chapter 6 Capsule Endoscope Image Observation Switching the playback mode Use the playback mode switching button on the main screen to switch between playback modes (see Figure 6.17). 2. Adjust button 3. Red button 1. Normal button Figure 6.17 1. Normal button Images are played back at the speed set by a user. The review speed is configurable (see “Changing the review speed” on page 157). 2. Adjust button The review speed is automatically adjusted.
Chapter 6 Capsule Endoscope Image Observation • Red color detection is automatically performed while downloading the image data from the recorder unit. • To display images before or after the image detected by the red color detection function, rotate a wheel of a mouse. Changing the review speed You can set the review speed for the image data using the speed setting bar in the image operation area on the main screen. The displayed review speed is approximated. 1.
Chapter 6 Capsule Endoscope Image Observation Speed display area Figure 6.20 Multi display function You can display 1, 2, or 4 images simultaneously. Use the image view buttons in the image display area to change the image view setting (see Figure 6.21). 1. 1-Image Display button 2. 2-Image Display button 3. 4-Image Display button Figure 6.21 1. 1-Image Display button Sets the number of images to be displayed in the image display area to 1. 2.
Chapter 6 Capsule Endoscope Image Observation 1 Display Mode • In the “2 Display Mode”, the image on the left side is 0.5 second older than the image on the right (see Figure 6.22). • In the “4 Display Mode”, the images shown in the upper left, upper right, and lower right are 1.5, 1.0, and 0.5 second older than the image on the lower left, respectively (see Figure 6.22). 2 Display Mode 4 Display Mode Figure 6.
