Capsule endoscopy (CE) is a useful modality to investigate the small bowel (SB). Since its invention in 2001, several iterations and prototypes have been developed¹. Pillcam Genius is a new technology where the data recorder has been replaced entirely with a link device which is placed on the patients’ abdomen. This allows the patient to post the link device back containing the data and hasten reaching a diagnosis. We conducted a pilot study to assess the utility of this new technology and acceptability of patients. 

This was a prospective multicentre site study of patients having Pillcam Genius. Demographic data and blood parameters, findings at CE and diagnosis, and follow-up data were collated.

A total of 30 patients from 4 sites in the United Kingdom, France, Italy and Germany underwent SB investigation with PillCam Genius from September 1^rst, 2025 to November 28^th, 2025. The median age was 72.5 years (52.0 -80.0) with 57% of females. The commonest indications were overt gastrointestinal (GI) bleeding (40%) and iron deficiency anaemia (IDA) (37%), and Crohn’s disease (17%). All procedures but one were completed (97%), with no cases of CE retention. About half (53%) of the CE were done in an outpatient setting, the remaining ones as inpatients.

In the 23 patients with suspected SB bleeding (overt and IDA), the median age was 76 years (57-83) and median ASA score was 2.5 (2-3). The diagnostic yield for P1 and P2 lesions was 57%, while for P2 lesions only was 22%. Management was altered in 26% (5-23), with suggested enteroscopy in 22% (4 patients) and starting treatment with somatostatin analogues in 4% (1 patient).

In patients with overt GI bleeding, the diagnostic yield for P1 and P2 lesions was 33%, while for P2 lesions only was 17%. The median time of CE from presentation of overt bleeding was 6.5 days (4.5-15). The mean small bowel transit was 4h30m (SD 2h06m). One patient had a rebleeding episode at 7 days, all other 11 patients did not have any rebleeding episodes at 7 days or at follow-up. The median follow-up time was 21 days (9-28).

All patients tolerated Pillcam Genius well and were satisfied with the minimalist technology.  

The pilot study has demonstrated that Pillcam Genius is a good addition to the current technology of CE with a high diagnostic yield. It has the potential to reduce travel burden of the patient and hence reduce carbon emissions. It also has the potential to offer a hub and spoke service to smaller  and more remote hospitals which do not have a CE service and reduce time to diagnosis particularly with large referral centres covering wide catchment areas.