Dr. Graham Gibb, General and Colorectal Surgeon, Discusses a Marvel of Medicine — The Endoscope Pill
For many reasons, the human intestine presents doctors with big challenges. One reason is that it’s over twenty feet long. Another is that it curls back and forth inside our bodies so that access to any specific part of it for either examination or surgery is difficult. The usual method of internal examination is to use an endoscope — a long thin flexible tube that is inserted through one of the patient’s orifices and fed to the desired location. Fiber optic cables within the tube deliver light from an external source and images of the illuminated internal organ are carried back to an external viewer/camera through further fiber optic cables. This is a reliable system, but it has limitations, one of which is that it can’t reach every part of the digestive tract, more specifically the small intestine. Enter the “magic pill.”
In 2001, the US FDA approved the use of a tiny cable-free endoscope, which could be swallowed by the patient. It is the size and shape of a vitamin pill and transparent at one end. Within this tiny pill is a miniature camera, several LED lights, a computer, a battery and radio transmitter. Some models don’t need a battery because they obtain their power by magnetic induction via a special belt worn by the patient. As the pill travels through the intestine, the camera continually takes pictures, which it relays wirelessly to an external receiver on the patient’s belt.
Yet, for all their cleverness, many pill endoscopes have one significant drawback: the camera faces forward, so that most images of the intestine wall — the tissue of most interest to the doctor — are peripheral and thus lack clarity. This problem has been tackled and solved by a new type of pill endoscope on the market since 2008, which was developed by the Japanese RF System Lab. The revolutionary device called the Sayaka Endoscope Capsule has a revolving camera that takes pictures of the intestine wall through the transparent side of the capsule. This pill is actually smaller than its predecessors even though it contains all their gadgetry — camera, lights, computer, and transmitter — plus the mechanism for rotating the camera. It takes about eight hours to pass through the intestines travelling just one inch ever two minutes. During that journey, the camera rotates 60 degrees every two seconds, recording approximately 864,000 images — 30 per second. The images are continually transmitted to an SD storage card on the patient’s belt. When the journey is completed, the SD card is transferred to a PC where special software joins all the images to create a detailed high-resolution video of the patient’s intestines. Doctors can replay this video or freeze sections of it to magnify an area of special interest. The pill endoscope, which costs about $100, is eventually excreted in a normal bowel movement and discarded.
“Fantastic Journey” is a sci-fi movie of the 1960’s, in which a group of scientists in their pill-shaped vessel are shrunk to a microscopic size and injected into the bloodstream of a Russian agent, so that they can tinker with his brain. The technology of the pill endoscope may not be as radical as that. Yet in a few years, thanks to the super-miniaturization promised by nanotechnology, doctors may well inject microscopic gadgets with incredible capabilities into our bodies, where they will perform non-invasive life-saving microsurgery while we relax in front of the TV watching reruns of “Fantastic Journey.”
About Dr. Graham Gibb:
Dr. Graham Gibb has been a practicing surgeon for 18 years. He received specialized training in colorectal surgery from the University of Texas and completed his postgraduate work in general surgery in Calgary, Alberta. When he can get away from the hospital, Dr. Gibb loves taking advantage of his new pilot’s license and take in the beautiful scenery in Peterborough, Ontario.
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