Lec 2 Medical Equipment Endoscopes

2. What is Capsule Endoscopy?
 Capsule endoscopy is the latest evolution in gastrointestinal
endoscopy and the first to enable complete investigation of
the small intestine.
 This middle part of the gastrointestinal tract cannot be
reached by traditional upper endoscopy or by colonoscopy.
 Capsule endoscopy was first used in humans in 1999.
 First publication on capsule endoscopy was published in
Nature in 2000:
 Iddan G, Meron G, Glukhovsky A, Swain P. Wireless
capsule Endoscopy. Nature. 2000; 405:417.

3. What is Capsule Endoscopy?
 Doctor will give a pill-sized video camera to
a patient to swallow. This camera has its
own light source and takes pictures of
small intestine as it passes through. These
pictures are sent wirelessly to a small
recording device that the patient wears
around his waist as a belt.
 The most common reason for doing
capsule endoscopy is to search for a cause
of bleeding in the small intestine (Obscure
Gastro Intestinal Bleeding).
 It may also be useful for detecting polyps,
inflammatory bowel disease (Crohn’s
disease), ulcers, and tumors of the small
intestine.

4. How Does It Work?
 Once swallowed, the capsule moves thorough the intestine via peristalsis and is
excreted in the stool.
 The tip will illuminate red, green and blue laser light helping in visualization.
 The camera takes two images per second as it sweeps the intestine and transmits
these images to eight lead sensor arrays, taped to the anterior abdominal wall.
 Leads are connected to a recording device worn around patient's waist as a belt for
the duration of the battery life, which is 6-8 h.
 Once the study is completed, the recording device and sensor arrays are removed.
Images (50000-60000 images total) are retrieved from the recording device and
downloaded to a computer with Reporting and Processing of Images and Data
(Rapid, Given Imaging) software to display the video images on a computer
monitor.
 This software includes a localizing system, blood detector and some features to
assist the interpreter for detecting active bleeding.

6. Endoscopy Procedure
 Capsule is swallowed by the patient like a conventional pill.
 It takes images as it is propelled forward by peristalsis.
 A wireless recorder, worn on a belt, receives the images transmitted by the
pill.
 A computer workstation processes the data to display video images on a
computer monitor..
 It is recommended that patients avoid magnetic fields such as magnetic
resonance imaging (MRI), and metal detectors until the capsule is excreted
in the stool, which usually occurs in 24-48 h.
 Small bowel preparation by either patient fasting or drinking clear liquids for
10 to 12 h (or even for 24 h) before the study.

8. Specifications
 Diameter:11 mm.
 Length :26 mm.
 Bullet Shape
 Battery Type : 2 Silver Oxide Cells
 Operation Temperature : 20 ~ 40 oC
 Storage Temperature : 0 ~ 50 oC
 Weight : 3.25g
 Light : 6 white LED
 Chemical Safety : Safe in pH=2 ~8

9. Features
 Takes 2 images per second.
 50,000 images are obtained during an 8 hour exam.
 Magnification:8x.
 Coating is non-adherent.
 Disposable

10. Inside a Capsule Camera

11. 1.Optical Dome
 Front part of the capsule.
 Bullet-shaped.
 Light Receiving Window.
 Non conductor material.
 Prevent infiltration of digestive fluids inside the
capsule.
 Easy propelling.

12. 2.Lens Holder
 Accommodates the lens.
 Lens is tightly fixed.
 Avoids dislocation of lens.
3.Lens
 Behind Light Receiving Window.
 Light through window falls on the lens

13. 4.Illuminating LED’s
 Present around the lens and CMOS sensor.
 Six LED’S are present arranged in donut shape.
5.CMOS Image Sensor
 140o field of view.
 Precise, detects objects as small as 0.1 mm.
 Detect a polyp, traditional endoscope can’t do.

14. 6.Battery
 Button shaped & 2 in number.
 Silver oxide primary batteries.
 Disposable and harmless.
7.ASIC Transmitter
 Application Specific Integrated Circuit.
8.Antenna
 Receives data from ASIC transmitter.
 Sends images to data recorder.

15. Movement Of Capsule Through
The Digestive System
 Data Acquisition & Storage Of Data On Computer
Data Recorder Computer

16. Images Obtained From Capsule
Images of lesions found in patients with obscure GI bleeding.
C D

17. Uses
 Obscure Gastro Intestinal Bleeding (OGIB)
 Crohn's Disease
 Mal-absorption Disorders.
 Tumors of the small intestine & Vascular Disorders.
 Chronic diarrhea.
 Evaluation of refractory iron deficiency anemia,
 Abdominal pain.

18. ]
Advantages Disadvantages
Simple procedure, Painless, no side effects . Patients with gastrointestinal strictures or
narrowing are not good candidates for this
procedure: pill will get stucked if there is
partial obstruction in small intestine.
Avoids risk in sedation and radiation. Facing difficulties in cases of:
–Pregnant women
–Small children
–Patients with swallowing disorders.
–Patients with pacemaker: there is a risk of
interfering with pacemakers due to the
proximity of the sensor arrays placed on the
patients’ chests, but no significant trials
have confirmed this fear.
Accurate, precise (view of 140o). Poorer quality of images as compared to
Fiberoptic scopes.
High quality images. The position of the capsule can not be
accurately controlled.
Efficient than X-ray , CT-scan,
normal endoscopy.
Very expensive
High sensitivity & specificity. Inability to do biopsy or any therapeutic
interventions.