PWE-029 Are 2 heads better than 1: randomised comparison of MiroCam single-tip v double-tip capsule endoscope

Introduction Advancements in capsule endoscopy (CE) have led to the introduction of double ended capsule endoscopes. With a second camera on the rear end, these capsules can collect double the number of images per second compared to single ended capsules, and provide a field of view of 340 degrees, potentially doubling the area of bowel mucosa visualised. This, however, comes at the cost of a greater size. The clinical benefit of this additional camera has not been confirmed. Methods Prospective randomised cohort study of single v double tip CE from March 2018 to January 2019. Capsule reading speed and reporting was done as per individual preferences. In double-tip studies, readers were advised to alternate between cameras based on which gave the best views. Primary outcome measures were the positive yield (PY) and diagnostic yield (DY). Secondary outcome measures were quality of bowel views, gastric transit time (GTT), small bowel transit time (SBTT) and completion rate (CR). Results 326 CE procedures were performed during the study period: 201 single-tip v 125 double-tip. There was no statistical difference between the PY and DY (147/201= 73.1% v 90/125= 72.0%, p=0.82 and 86/201= 42.8% v 59/125= 47.2%, p=0.44 respectively). Despite the size difference, the transit times and completion rates between the 2 capsules were also similar (Median GTT 25 min v 28 min, p=0.22, Median SBTT 259 min v 247 min, p=0.35, CR 177/201= 88.1% v 114/125= 91.2%, p=0.37). Bowel views was reported as poor in significantly fewer double-tip than single-tip capsules (4.7% v 27.3%, p Conclusions Although this study demonstrates that the double-tip capsule provides better views of the bowel mucosa than single-tip, due to the ability to alternate between camera sides, this did not translate into higher diagnostic yields. It may be that a different protocol for reading is required for the double-tip capsule to maximise use of the improved field of view, such as viewing both cameras simultaneously. The size of the capsule was not shown to affect the transit or completion rate.