CAPSULE

CAMERA
 A
PILL
WIT
H
A
VIE
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What is capsule endoscopy?

•Capsule endoscopy is a novel

noninvasive technology designed
primarily to provide diagnostic
imaging .
 HISTORY

This Miniature Ingestible

Camera was conceived by
Tarun Mullick developed in
late 1980's with the help of
gastroenterologist, Dr. Sudhir
Dutta.
 The Camera Pill

Swallowable Camera Capsule,

from Given Imaging, including
Zarlink’s ULP RF Transmitter
 Specifications
§ Diameter of 10 mm and a Length of 20 mm.
§
§ Bullet shape - This shape and its diameter are critical for
mapping the small intestine.

§ Uses Silver oxide button batteries - high energy density &

disposable.

§ Made up of biocompatible material.

 Features of the Capsule

•Capsule takes two images per second

•On average, 50,000 images are obtained during an
8 hour exam
•Magnification: 8x
•Capsule coating: non-adherant
•Disposable
CONSTRUCTION OF CAPSULE
CAMERA
- HAS 8 PARTS
 CAPSULE
CAMERA(Internal view)

Capsule
Electronics
1.Optical dome
2. Lens holder
3. Lens
4.Illuminating

LEDs
5. CMOS imager
6 .Battery
7. ASIC transmitter
8. Antenna
 1.Optical Dome

Front part of capsule Bullet shaped

Easy orientation Easy propelling
 2.Lens Holder

Lens Holder holds lens tightly & avoids its dislocation.

 3.Lens

Arranged behind Light Receiving Window

Focuses light on the CMOS Image Sensor behind it.
 4.CMOS Image Sensor

PIXEL READ CODING SWITCHING

ARRAY CIRCUIT CIRCUIT CIRCUIT

OSCILLATI CURRENT
CONTROL LIMITING
NG CIRCUIT CIRCUIT
CIRCUIT
 5.Battery

Button shaped & two in number

Made of Zinc/Alkaline Electrolyte/Silver Oxide
Has discharge voltage, disposable and doesn’t cause harm to the
body.
 6.ASIC Transmitter

The ASIC (Application Specific Integrated Circuit) Transmitter

Two Transmitting Electrodes are connected to the outlines of the
ASIC Transmitter.
These electrodes are electrically isolated from each other.
7.Antennae

The dome containing the Antennae is made of non conducting

material which is harmless to the human body.
Parylene coated onto polyethylene or polypropylene is used.
As shown, the Antennae is arranged at the end of the capsule. It
is enclosed in a dome shaped chamber.

it to the Data Recorder tied to the patient’s waist.

The Antennae receives the data from the ASIC Transmitter and sends
PillCam Platform
Components
• PillCam ESO or
SB
• Data Recorder
• Given
Workstation
• RAPID
Software
 Data Recorder with pick up
antennae & a Computer.

A view of Data Recorder being

mounted on a belt pack tied
to the patient’s waist.
SB 2 with RAPID 4 SB 2 with RAPID 5
 Improved Diagnostic Confidence:
RAPID Atlas
• All images reviewed
and labeled by
physician advisory
panel.
• Enables side-by-side
comparison of case
image to known
pathology.
• Searchable by Capsule
Endoscopy Structured
Terminology (CEST),
findings, and diseases.
 TYPES AND
APPLICATION
-4 TYPES
PillcamSB
•Approved by FDA in 2001
•Size-11mm x 26 mm
•Weight-3.7 grams
•One-sided imaging
•Two pictures per second
•1:8 magnification
•140 degree field of view
•Over 50,000 images in 8
hours
•PillcamSB 2-cleared by FDA
May 2007-offers wider field
of view and improved optics
PillcamESO
•Approved by the FDA in
2004
•Size 11mm x 26mm
•Weight-3.7 grams
•Two sided photography
•14 images per second
•2,600 pictures in 20 minutes
•PillcamESO 2-cleared by
FDA May 2007-offers wider
field of view and 18 images
per second
Agile Patency Capsule
•Same size as actual video capsule
•Composed of lactose
•Contains a timer, radiofrequency
identification tag, and radio-opaque material
•Can be seen by plain abdominal film or by
special handheld radiofrequency detector
•Designed to progressively dissolve after 40
hours of contact with digestive secretions
•Disintegrates completely between 80 and 100
hours
•Allows localization of site of stenosis before
video capsule
•Not considered standard of practice
 Uses

PillCam™ SB- Crohn's Disease, Small bowel

tumors, Small bowel injury, Celiac Disease, Mal-
Absorption Disorders, Vascular Disorders,
Ulcerative Colitis
PillCam™ ESO -esophageal diseases, gastro esophageal
reflux disease, Barrett's esophagus PillCam™ COLON-
colon
Agile™ patency capsule- intestinal patency
EXISTING PRODUCTS
1.OMOM 2.M2A
3.PILLCAM 4.NORIKA3
5.MTSI
Preparation
§Patient fasts overnight or for at least 12 hours
§No iron pills for 5 days or olestra
§Colyte prep: clear liquid diet at noon, 2/3 gallon
colyteat 6 PM, 4 hours prior to capsule take 1/3 gallon
colyteand 2 simethicone tablets
§Magnesium Citrate prep: clear liquid diet at noon, 1
bottle of magnesium citrate followed by 1 bottle of
gatoradeat 6 PM, 8 PM and 4 hours prior to capsule with
2 simethicone tablets 4 hours prior
Procedure for PillcamSB
Ø•Patient comes to endoscopy center
Ø•8-lead antenna placed on patient and battery pack placed
on patient
Ø•Patient swallows pill and leaves unit
Ø•Can ingest liquids 2 hours after capsule taken
Ø•Can eat food 4 hours after capsule taken
Ø•Patient brings back recorder approximately 8 hours after
ingestion
Ø•Patient does NOT recover capsule
Ø•Recorder then downloaded onto computer which can
take 2.5 to 3 hours
Ø•Capsule then read on computer
Procedure for PillcamESO
Ø•Patient swallows the pill while lying down
with little or no water
Ø•The patient is then slowly elevated
Ø•This allows for the capsule to spend a longer
time in the esophagus and therefore allow for
better visualization of the esophagus
 Endoscopy Procedure

Ø Capsule is swallowed by the patient like a conventional pill.

Ø It takes images as it is propelled forward by peristalsis.

Ø A wireless recorder, worn on a belt, receives the images

transmitted by the pill.

Ø A computer workstation processes the data and produces a

short video clip or still images.
The Diagnostic Procedure
Capsule
Imaging
• Moved by
peristalsis
• 2Hz, 576 X576
color image
• Typical studies are
around 6-8
hours.
• 10,000s of images
from each
study
• Somewhat
cumbersome to
 In approximately eight hours, the
patient will return to the clinic for
removal of equipment.

9:00 am 5:00 pm
 Advantages
§ Painless, no side affects or complications.
§Miniature size, so can move easily through the digestive system.
§ Accurate, precise & low power consumption.
§Images taken are of very high quality which are sent almost
instantaneously to the data recorder for storage.
§
§Made of bio compatible material, doesn’t cause any harm to the body.
§
§The procedure is simple.
§Use of Suspected Blood Indicator (SBI)which add no cost.
§
§AdvanCE (Advance CE) for patients unable to swallow
§
§High sensitivity and specificity for detecting lesions.
§
§CE avoids the risks associated with sedation and radiation.
§
§It is noninvasive and may not require the patient to miss work.

§Reducing physician reading times and improving cost-effectiveness.

§
§More efficient than normal endoscopy,the X ray or the CT scan.

§Remote interpretation for rural settings

Image Spectrum: PillCam Capsule Endoscopy

Suspected Crohn’s
Bleeding

Celiac Disease

Tumors
 Capsule Endoscopy Versus Other
Imaging Modalities

Study Yield

Capsule vs Ileoscopy 61% vs 46%

Capsule vsPush enterosc 51% vs 7%
Capsule vs CT enterography 75% vs 37%
Capsule vs Small bowel MRI 60% vs 40%
 Disadvantages
Gastrointestinal obstructions and swallowing disorders prevent free flow of
capsule through the digestive system.
Patients with pacemakers, pregnant women and all pediatrics have to be
monitored continuously while taking the capsule.
The M2A procedure is not a replacement for Colonoscopy.
It is not reusable.

Capsule obstruction which necessitate surgical removal

More expensive than the other procedures

Batteries may not last long

Presence of cardiac pacemakers and cardiac defibrillators could lead to

corruption and loss of the transmitted data.

MRI not possible while the capsule inside the patient's body
v
 CAPSULE ENDOSCOPY
RETENTION

• Capsule retained proximal to an intestinal narrowing for at

least TWO WEEKS.

• Untreated, may be permanent.

• Capsule removal requires medical endoscopic or surgical

intervention
 Future Improvements

§Equipping the capsule with a LASER.

§ Adding additional features like Zooming & Auto
Focus.
§ Can be used in Restorative Surgery &
Pharmacological Intervention.
§ Further reduction in size using Nano Technology.
§Making it cost effective.
§
§SB2 with new features mm
§RAPID® REAL TIME VIEWER
§Labeling the bowel wall, sample luminal
contents, biopsy the mucosa, provide therapeutic
ablation of lesions, or control the movement of the
device.
§Evaluation of celiac sprue and chronic abdominal
pain.
§Longer battery half-life
§Humanoid robot
§Capsule camera with telemetric capacities
§Making it cost effective.
RAPID® REAL TIME
VIEWER
� Remote Patient
Check-in
� Real-time viewing
� Data Transfer to GDS
� PillCam ESO Viewing
 Conclusion

The Endoscopy capsule is a pioneering concept for Medical

Technology of the 21st century.
The endoscopy system is the first of its kind to be able to provide non-
invasive imaging of the entire small intestine.
It has revolutionized the field of diagnostic imaging to a great extent
and has proved to be of great help to physicians all over the world.
THANK YOU