Robotic capsule endoscopy (RCE) is an emerging technologythat combines magnetically controlled gastric navigation with conventional capsuleenteroscopy (CE), enabling a minimally invasive, comprehensive evaluation of the upperand mid-gastrointestinal tract. This study aimed to characterize the real-worldimplementation and diagnostic performance of RCE in a European tertiary referralcenter. 

A retrospective, single-center analysis was conducted on adultpatients (≥18 years) who underwent RCE between June 2023 and June 2025. Eligiblepatients had a clinical indication for small bowel CE and a concurrent requirement fordiagnostic gastroscopy or reassessment of known gastric lesions. The RCE protocolcomprised an initial robotic-guided gastric examination followed by passive transitthrough the small bowel. 

A total of 85 patients were included (52% female) witha median age 49 years (IQR 40-64). The most common indications were suspected orestablished inflammatory bowel disease (57%) and iron deficiency anemia (31%).Gastric preparation was rated at least fair in 98% of cases, with good preparation in38%. Median gastric transit time was 74 minutes (IQR 35-106). Relevant gastric findingswere identified in 39 cases (46%), namely polyps (18%) and angiectasias (8%, includingone with active bleeding), in addition to signs of chronic gastritis. Thirteen patientsunderwent subsequent endoscopy, resulting in seven therapeutical procedures. Smallbowel findings were present in 60 patients (71%), including P3 (active bleeding) in 3%and P2 lesions (angiectasias, ulcers, tumors, varices) in 39%. One clinically significantadverse event occurred: small-bowel capsule retention in a patient with multifocalneuroendocrine tumor and ileostomy. 

Robotic capsule endoscopy is afeasible and effective tool for dual-region gastrointestinal evaluation. It enables high-quality gastric visualization, facilitates early detection of clinically actionable lesions, andmaintains the diagnostic yield expected from standard small bowel CE. These findingssupport the integration of RCE into diagnostic pathways for patients requiringsimultaneous gastric and small bowel assessment.