pillcam

Wireless Capsule Technology


ABSTRACT
Endoscopy is a minimally invasive diagnostic medical procedure used to assess the interior surfaces of an organ by inserting a tiny tube into the body, often, but not necessarily, through a natural body opening. Through the scope one is able to see lesions and other surface conditions
This paper mainly projects the applications and advantages of the PillCam that has brought a revolution in the field of endoscopy
The PillCam capsules are miniaturized disposable color video cameras encased in a plastic shell, which incorporate one or more specially developed imaging devices based on complementary metal oxide semiconductors_(CMOS)_technology. About the size of a large vitamin, the capsule is made of specially sealed biocompatible material that is resistant to stomach acid and powerful digestive enzymes.

Another name for this new technique is Wireless Capsule Endoscopy .
It is expected that the discussion of these key items provides a view towards the future of endoscopy.
Major advances in endoscopic technology have occurred over the past 30 years—advances that have transformed the field from one of purely diagnostic applications to one including therapeutic applications. Technological innovations will facilitate advances in our ability to perform minimally invasive endoscopic surgery, optimize patient comfort during procedures, and ultimately lead to improved outcomes in patients with gastrointestinal disorders.

PILLCAM

Wireless Capsule Endoscopy


Introduction
Endoscopy is a diagnostic medical procedure used to assess the interior surfaces of an organ by inserting a tiny tube into the body, often, but not necessarily, through a natural body aperture..Through the endoscope lesions and other surface conditions can be observed.
The instrument may have a rigid or a flexible tube that not only provides an image for visual inspection and photography , but also enables in making biopsies and retrieval of foreign objects from the body. Endoscopy is the vehicle for minimally invasive surgery .
Many endoscopic procedures are relatively painless and, at worst, associated with mild discomfort, even though patients are sedated for most procedures. Complications are rare (only 5% of all operations) but can include perforation of the organ under inspection with the endoscope or biopsy instrument. If that occurs open surgery may be required to repair the injury.

Earlier Method
Earlier methods used a fibre which was inserted and helped in transmitting the pictures of the digestive track.
The following figure shows a typical Endoscope

Endoscopes consist of three tubes; a light emitting fibre, a fibre which transmits the image to the physician and tube which can be used for the administration of drugs as well as having the ability to hold a brush or incisor instrument for the removal of damaged body tissue or for taking tissue samples.
In the earlier endoscopy methods, a half inch diameter tube is sent inside the body through throat. If there is any difficulty with the patient in swallowing the tube, his/her throat is sprayed with a sedative whichsedative, which makes the job easier and less painful.

Disadvantages of Earlier Methods
Physical : Introduction of unsterilised instruments into the body is always a possibility. Inexperienced handling of the endoscope, both rigid and flexible, or the equipment supported by it can lead to punctured organs with variable effects.
Dyes : Contrast agents or dyes (such as those used in a CT scan) that are used for imaging can cause allergic reactions. Iodine in these dyes is also a cause of allergic reactions. the dyes are specialy harmful to the kidneys. Weak kidneys exposed to the dyes can result in renal failure. If there is such a risk the physician needs to be questioned about the necessity of the procedure. The patient should also ask about how to promote flushing the dye and how to recover from kidney damage. Patients on dialysis should be dialyzed after the procedure to flush out the dyes.
Sedation : Experienced anesthesiologists will provide sedation only in required amounts to keep the patient comfortable. Over-sedation can result in dangerously low blood pressure and nausea and vomiting. Nausea and vomiting are especially dangerous as these prevent the patient from drinking to flush the dyes out of the kidneys.
Diseases tested by Endoscopy
• Ulcers
• Cancer
• Internal Bleeding
• Gastrointestinal disorders

Revolution in Endoscopy
In 1981, an Israeli physician, Dr. Gavriel Iddan, began development of a video camera that would fit inside a pill. Technology was not ready and the idea was put on hold. It took 20 years for technology to catch up with Dr. Iddan. In 2001, the FDA approved the Given Diagnostic Imaging System . This may sound like science fiction, but this 11 x 26 mm capsule weighs only 4 gms (about 1/7 th of an ounce) and contains a color video camera and wireless radiofrequency transmitter, 4 LED lights, and enough battery power to take 50,000 color images during an 8-hour journey through the digestive tract. About the size of a large vitamin, the capsule is made of specially sealed biocompatible material that is resistant to stomach acid and powerful digestive enzymes.
Another name for this new technique is Wireless Capsule Endoscopy
What is Capsule Endoscopy?
. The PillCam capsules are miniaturized disposable color video cameras encased in a plastic shell, which incorporate one or more specially developed imaging devices based on complementary metal oxide semiconductor (CMOS) technology. Other components include optics; white-light emitting diodes for illumination, and an application-specific integrated circuit device for control and image transmission, low-power silver oxide batteries, an antenna and other discrete electronic components. The RAPID software, when used with the PillCam SB capsule, creates a graphic representation of the patient's gastrointestinal tract, helping physicians assess the location of the PillCam SB capsule within the body when an image is captured and assisting them in directing treatment to the affected area. The Company is selling PillCam capsules designed for visualization of two areas of the gastrointestinal tract: the small bowel and the esophagus.

The PillCam SB capsule transmits images at a rate of two images per second for approximately eight hours, resulting in approximately 50,000 images, at which time the operation is stopped and recording ceases. The PillCam SB capsule is used with a range of indications of the small intestine, including obscure bleeding, suspected Crohn's disease, iron deficiency anemia and suspected small bowel tumors. The PillCam ESO capsule contains an imaging device and light source at both ends of the capsule and is designed to capture up to 14 images per second as it passes down the esophagus. The PillCam ESO capsule can be used only with DataRecorder 2.0 or newer versions and RAPID 3.0 or newer versions. The AGILE Patency System consists of the AGILE Patency capsule, a dissolvable capsule the same size as the PillCam with a radio frequency identification (RFID) tag packed in a lactose and barium powder.
In November 2004, the Food and Drug Administration cleared the PillCam ESO for use in adults to help detect abnormalities in the esophagus. In 2001, the agency cleared the PillCam SB for detecting problems in the small bowel, or small intestine, in adults and children at least 10 years old.
Uses
• Physicians use the PillCam ESO to look for conditions such as gastroesophageal reflux disease (GERD). GERD occurs when a muscle valve in the esophagus malfunctions, allowing stomach acid to flow up into the esophagus and cause heartburn. Left untreated, GERD may lead to a pre-cancerous condition called Barrett's esophagus.

• Use of the PillCam ESO for patients “who are reticent to have an upper endoscopy but are still concerned that they may develop problems such as Barrett's esophagus.” Capsule endoscopy, as with traditional endoscopy, can help guide treatment.


• The PillCam SB, which views the small intestine, can help determine the cause of persistent abdominal pain, unexplained rectal bleeding, or diarrhea. Physicians use it to detect polyps, cancer, and other causes of bleeding and anemia, such as Crohn's disease, a chronic inflammation of the digestive tract that can cause abdominal cramps, diarrhea, and anemia.


• The PillCam can see lesions that indicate sources of gastrointestinal bleeding,


• Crohn's disease is not apparent on X-rays but can be detected with the use of the PillCam


• The PillCam SB allows doctors to see the entire 20-foot-long small intestine; The battery has an eight-hour life expectancy, which generally is long enough to photograph the small intestine


DESCRIPTION:

b- it helps to increase the viewable surface area of the camera.


• Lens holder- it is placed in between the dome and the lens, which helps to keep the lens in its proper position.





• Lens- the most vital component of the camera which is responsible for the picture capturing.

• Illuminating LED's- this is the light source which is placed behind the lens which provides the light in order to get a clear picture of the parts of the body.

• - this is the component that helps in the storage of the pictures taken by the PillCam.

• Battery- the key for the working of the PillCam inside the body. It has a life period of 8-10 hrs.

• ASIC - it's a transmitter,which transmits the recorded data to the output source.

• Antenna - antenna helps in the wireless connection of the output source n the PillCam.
Procedure
A person must fast for 10 hours prior to undergoing capsule endoscopy for the small intestine, but can eat four hours after swallowing the capsule. Lewis says he schedules patients early in the morning, so they can eat lunch and dinner. Wire leads with sensors on the end are affixed to the patient's abdomen and connected to a data-recording device worn on a belt around the waist.
The PillCam SB takes about eight hours to move through the small intestine, taking two pictures per second with its single camera. During this time, the person can leave the doctor's office and go about a regular routine while wearing the sensors and recorder. Later, the person returns to hand over the sensors and data recorder. The physician downloads about 57,000 color images into a computer, which compresses them to form a video.The physician then views the video on a monitor to determine the next step in treatment.A two-hour fast is required before taking the PillCam ESO, which views the esophagus. Wire leads with sensors are placed on the patient's chest and connected to a recording device. The person swallows the capsule with water while lying flat on the back. Every two minutes over a six-minute period, the person is raised by 30-degree angles until sitting upright, then remains upright for an additional 15 minutes to make sure the capsule has traveled through the entire esophagus. The gradual rise to a sitting position slows down the movement of the PillCam ESO, giving it additional time to take pictures. In contrast to the PillCam SB, which moves slowly through the snake-like turns of the small intestine over several hours, the PillCam ESO “moves through the esophagus in minutes,” says Cooper. Given Imaging added a second miniature camera to the ESO capsule, putting one camera at either end, to take about 2,600 total color images of the esophagus .


CONTRAINDICATIONS:
• Known or suspected gastrointestinal obstruction, strictures and fistulas
• Cardiac pacemakers or other implanted electromedical devices
• Swallowing disorders

Conclusion
It is hoped that this discussion of these key presentations provides a view toward the future of endoscopy. Major advances in endoscopic technology have occurred over the past 30 years—advances that have transformed the field from one of purely diagnostic applications to one including therapeutic applications. Technologic innovations will facilitate advances in our ability to perform minimally invasive endoscopic surgery, optimize patient comfort during procedures, and ultimately lead to improved outcomes in patients with gastrointestinal disorders.
REFERENCES:
www.google.com
www.askjeeves.com
www.medicalnewstoday.com
www.medgadget.com
www.abcnews.go.com