Capsule Endoscopy. Andy Dion Ryan Tirtariyadi

Transcription

1 Capsule Endoscopy Andy Dion Ryan Tirtariyadi

2 Outline Anatomy of the GI tract Diseases Conventional Endoscopy Capsule Endoscopy Current Technology Future Concepts/Developements

3 The G.I. Tract 7.5 meters long Upper GI tract Mouth -> esophagus Lower GI Tract Bowel (Intestine) Small intestines Large Intestines

4 Diseases of the GI Tract Ulcers Drug/food induced inflammations (NSAID) Bleeding Tumors Cancers Parasites

5 What is Endoscopy All these diseases are very visible, but they re on the inside of your body Most GI diseases affect the Mucosa layer which comes in direct contact with the food (or bolus). Easily diagnosed if doctors can See it. Endoscopy allows doctors to visualize the GI tract Two ways to look inside: Exploratory Surgery Endoscopy

6 Endoscope

7 Types of Endoscopy

8 Pros / Cons Quick Can fix things (cautery) Can grab tissue samples (biopsy) Manual control

9 Small Intestines Duodenum (20cm) Jejunum ( cm) Illeum ( cm) 1/3 the diameter of the Large intestines 4-5x the length of the Large intestines

10 Small Intestine Disorders

11 Capsule Endoscopy Small intestine is Too convoluted Too long Capsule endoscopy is wireless Can see the entire length of small intestine

12 Brief History Started by Gavriel Iddan Formerly an Israeli scientist working on guided missile technology Inspired by his friend who suffers from chronic abdominal pain

13 Early Capsules Other capsules were developed Measures ph, temperature, pressure

14 Current Technology PillCam SB/ESO Norika3 and Sayaka MiRO

15 PillCam (May 2001) Camera at the tip of the capsule Strobe LEDs sync-ed with picture taking 2 frames per second CMOS sensor (190, ,000 pixels) Battery powered 26 x 11mm US$450 each

16 Norika3 (December 2001) Camera at the tip of the capsule (slightly angled downwards for better exposure) Focus adjustment Wireless power transmission Posture control Simulated 3D images by LED manipulation 30 frames per second CCD Sensor (410,000 pixels) 23 x 9mm US$100

17 Sayaka (Dec 2005) Camera on the side of the capsule Twin layered capsule (camera rotation) Stepping rotation using electromagnets Creates a flat map of the entire GI tract 30 frames per second (870,000 pictures over 8 hour) CCD Sensor (410,000 pixels) Focus adjustment 2MB/mm2 75x magnification on 17 display Wireless power transmission

18 MiRO In development 320 x 320 pixel resolution f/sec (focusing capabilities) Localization (Reverse Telemetry) Real time image acquisition Displays to a PC/PDA 11 x 24mm Battery powered

19 Pros Non-invasive Can access the entire small intestine No need for exploratory surgery Cheap Time-efficient

20 Cons Lack of control Pill can get stuck Cannot further examine areas of interest Camera view might be obscured by bowel contents

21 Development Challenges How to create a device small enough, and comfortable enough to swallow while packing sophisticated electronics. The microelectronics must be able to take high resolution pictures, transmit the data back, and operate for at least 6-8 hours. How to give user more control over the capsule s movement and camera direction

22 Anatomy of the Pill

23 Size Size reduction means removing unnecessary components Batteries are typically large and carries limited amount of power Micro-devices: Biopsy tools Drug sprayers Laser or Cautery devices (+power supply)

24 Section Drawings

25 Power Batteries typically do not carry enough power to last the desired amount of operation time. Batteries can be toxic if leaked into the digestive system Solution: Remove the battery Wireless power transmission offers the possibility of unlimited operation time, size reduction, and no risk of toxin contamination

26 Block Diagram Wireless power transmission Splitting the DSP from the imaging CCD circuit allows for 94% of the power consumption to be handled externally

27 Image Resolution Images taken must be clear, sharp, and have good colour definition CCD vs. CMOS Focus adjustment Simulated 3D (depth perception)

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29 Movement Control Norika3 uses Electromagnet induced Posture Control Sayaka uses Electromagnets to produce Stepping Rotations MiRO sends telemetry back to inform user of current position

30 Posture adjustment

31 Pictures

32 Normal intestinal lining Lymphoma PillCam SB Crohn s Cystic erythema inflammation

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35 Videos

36 PillCam SB

37 Norika3

38 Norika3

39 Future Developments Drug delivery Micro-biopsy Laser treatments Additional sensors (ph, Temp, pressure sensors) Cost reduction

40 Last Comments Capsule endoscopy marks a leap in the quality of care for patients Pills for Small intestine visualization are available today Next step, the Sayaka capsule will allow for visualization of the entire Gi tract Very painless, low-cost procedure with high degree of accuracy Future pills can be controlled and will be involved in treatment process and more involved diagnosis techniques

41 Questions?

42 References A. Arshak, K.Arshak, D. Morris, E.Jafer, O. Korostynska, G.Lyons, & D. Waldron. A Review of Digestible Microsystems for Gastrointestinal Tract Diagnostic Applications In: Critical Reviews in Biomedical Engineering, 34(2): (2006) IEEE Standard for Safety levels with Respect to Human Exposure to Radio Frequency, Electromagnetic Fields, 3kHz to 300GHz. In: IEEE Standard c New York: IEEE; Glukhovsky A, Jacob H. The Development and application of wireless capsule endoscopy. Int J Med Robot Comput Assist Surg. 2004; 1(1): Iddan G, Meron G, Glukhovsky A, Swain P. Wireless Capsule Endoscopy. Nature. 2000; Norika3. Data Sheet; RF System Adopts Silicon Laboratories Small Form Factor Microcontroller for Advanced Medical Application. In: Business Wire. Aug. 09, 2006 Tortora G. J., Derrickson B. Principles of Anatomy and Physiology 11th Edition. John Wiley & Sons U.S sys_009.html

43 References (Cont d)

44 Thank you