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Capsule Endoscopy

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CAPSULE ENDOSCOPY AS AN APPLICATION
OF MEDICAL IMAGING

ABSTRACT :- Video capsule endoscopy (VCE) recently introduced fills the gap between examinations of the upper and lower gastrointestinal tract, mainly to examine the small bowel (SB) for sources of obscure bleeding in addition to many other indications. VCE represents a minute endoscope, embedded in a swallowable capsule that is propelled by peristalsis and achieves the journey to the right colon in 5-8 hours. Images captured by the capsule are recorded on a hard drive attached to the patient's belt. Many studies have recently shown that the diagnostic yield of VCE is superior to that of push enteroscopy. It is well known that radiological investigations of the small bowel (SB) have a limited diagnostic yield, are relatively invasive, and often lead to late discovery of diseases, especially malignancy and profuse bleeding, at a worse stage. Also, push enteroscopy is limited by the depth of the insertion of the instrument to the proximal jejunum and, in the retrograde, to the last 50-80 cm of the terminal ileum, with an ability to visualize the entire SB only in 10-70% of cases. Introduction of video capsule endoscopy (VCE) is therefore regarded a significant advance in investigating intestinal diseases.

INTRODUCTION

A few years ago, the assessment of small bowel pathology was a major dilemma, especially when it came to the management of obscure gastrointestinal bleeding. Evaluation of the patients was frequently unsatisfactory because of the inability to completely visualize the small bowel mucosa with the available endoscopic and radiological techniques. Capsule endoscopy (CE) was launched at the beginning of this millennium and since then has had a very important impact on managing obscure gastrointestinal bleeding and many other small bowel diseases.

HISTORY OF ENDOSCOPES
Lichteiter - Bozzini (1805)

Flexible Gastro scope - Dr. Schindler (1932)

Fiberscope – Olympus Corp. (1975)

Early prototype with gastrocamera
A model with a thinner tube

CAPSULE ENDOSCOPY

Capsule Endoscopy involves ingesting a small (the size of the large vitamin pill) capsule, which contains a colour camera, battery, light source and transmitter. The camera takes two pictures every second for eight hours, transmitting images to a data recorder about the size of a portable CD player that patients wear around the waist.

Capsule endoscopy assists in diagnosing gastrointestinal conditions such as obscure gastrointestinal bleeding, malabsorption, chronic abdominal pain, and chronic diarrhoea.

Once swallowed the camera moves naturally through the digestive tract while patients carry out their normal activities. Approximately eight hours after ingesting the camera, patients return the recording device to their doctor or nurse so the images can be downloaded to a computer and evaluated. The Capsule endoscope is disposable and will be excreted naturally in your bowel movement. In the rare case that it will not be excreted naturally, it will need to be removed endoscopically or surgically.
Capsule endoscopy is the least invasive and most direct way for doctor’s to see the entire small intestine and esophagus. Hundreds of clinical studies conducted by the world’s leading gastroenterologists have shown the value of the PillCam video capsules in helping doctors diagnose or rule out disorders of the GI tract.

DESIGN DETAILS
Complete structure of capsule:-
EXTERNAL APPEARANCE

The video capsule measures 11 mm x 26 mm and weighs less than 4 grams. It contains an imaging device and light-source on one-side and transmits images at a rate of 2 images per second generating more than 50,000 pictures over an 8-hour period.

INTERNAL STRUCTURE

1.Optical dome 2. Lens holder 3.Lens 4.LED’S 5. CMOS imager 6. Battery
7. ASIC transmitter 8. Antenna

ACCESSORIES 1. 2. DATA RECORDER

It is a real time viewer consisting of temporary storage unit having a flash memory of 1GB.

2.SENSOR ARRAY

3.COMPUTER Day of capsule endoscopy

Before CONCLUSION

Capsule endoscopy continues to improve technically. It has revolutionized diagnosis by providing a sensitive (able to identify subtle abnormalities) and simple (non-invasive) means of examining the inside of the small intestine. Small intestine diseases diagnosed by capsule endoscopy include: 1. Angiodysplasias 2. Small intestinal tumors such as lymphoma, carcinoid tumor, and small intestinal cancer 3. Crohn's disease of the small intestine.

REFERENCES:-
Galmiche JP, Coron E, Sacher-Huvelin S. Recent developments in capsule endoscopy.
Nakamura T, Terano A. Capsule endoscopy: past, present, and future. J Gastroenterol. www.wikipedia.com www.google.com

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