To evaluate the retrieval rate of capsules for environmental motivation after videocapsule endoscopy (VCE), considering demographic and travel-related factors

This is a prospective monocentric study enrolling patients undergoing VCE at the Endoscopy Unit of the Policlinico of Milano, a tertiary referral center in a urban area. Patients were invited to retrieve the capsule on the basis of its environmental impact. Data collected included age, travel distance, number of transportation mens, travel time and out-of-pocket costs. Differences were assessed between patients who retrieved capsule after its evacuation and those who did not. Associations were analyzed using descriptive statistics and Pearson correlations. 0.04 kg of CO2 has been considered as a single capsule carbon footprint.

142 patients were enrolled (51% females, mean age 53 years, range 14–88). Main indications were celiac disease (22%), IBD (35%) OGIB (27%). 58 (41%) of capsules has been correctly retrieved and returned to the Endoscopic Center. The median travel distance was 11.5 km (mean 41.3 km, SD 151.1). Patients travelled with an average of 1.4 transportation means, with a median travel time of 40 minutes (mean 50.8 min, SD 43.3) and a mean travel cost of 12 euros (median 5 euros, SD 16.3). No statistically significant differences emerged between patients who reported VCE and those who did not regarding age, travel distance, means, time, costs or VCE indication. Moderate correlations were observed between travel time, distance, and expenditure. The carbon footprint of retrieved capsules 2.32 kg of CO2.

In this study, roughly half of the patients retrieved capsules after VCE due to an environmental motivation, demonstrating a sensitivity regarding this issue. Capsule retrieval after VCE was not associated with differences in demographic or travel parameters. However, substantial travel distances and associated costs underline the importance of addressing logistical barriers to optimize equitable access to diagnostic endoscopy and limitate environmental impact of VCE. Although the carbon footprint of capsules is low, the most important factor is the recylce of rare and environmentally dangerous material. Further research is warranted to evaluate targeted interventions for patient support and service decentralization to improve outcomes and reducing Capsules dispersion.