PillCam® SB3 capsule: Does the increased frame rate eliminate the risk of missing lesions?

Since its emergence in 2000, small bowel capsule endoscopy (SBCE) has assumed a pivotal role as an investigation method for small bowel diseases. The PillCam(®) SB2-ex offers 12 h of battery time, 4 more than the previous version (SB2). Rahman et al recently found that the PillCam(®) SB2-ex has a significantly increased completion rate, although without higher diagnostic yield, compared with the SB2. We would like to discuss these somewhat surprising results and the new potentialities of the PillCam(®) SB3 regarding the diagnostic yield of small bowel studies. PillCam(®) SB3 offers improved image resolution and faster adaptable frame rate over previous versions of SBCE. We recently compared the major duodenal papilla detection rate obtained with PillCam(®) SB3 and SB2 as a surrogate indicator of diagnostic yield in the proximal small bowel. The PillCam(®) SB3 had a significantly higher major duodenal papilla detection rate than the PillCam(®) SB2 (42.7% vs 24%, P = 0.015). Thus, the most recent version of the PillCam(®) capsule, SB3, may increase diagnostic yield, particularly in the proximal segments of the small bowel.