New technology offers unique view inside small intestines

Researchers at Stanford School for Medicine in the US have tested an ingestible, pill-sized camera dubbed the M2A that detects bleeding in the small intestine.The device, developed by Israel-based Given Imaging, Ltd., is said to provide doctors their only glimpse inside this hard-to-view organ without invasive surgery.

Jacques Van Dam, MD, PhD, professor of medicine at the Stanford School of Medicine, recently used the miniature camera on his second medical centre patient. The first two patients are part of a clinical trial of the M2A capsule in people who need regular transfusions due to bleeding. In a separate trial, Stanford researchers will test the device in anaemic patients who do not yet need transfusions.

To detect bleeding in the throat, stomach or colon, doctors use an endoscope, which is a camera on the end of a long, flexible rod. But endoscopy may fail to show the source of bleeding, leading doctors to suspect the small intestine.

With no device for viewing inside the deepest portions of the small intestine, however, exploratory surgery within the 20-foot long organ is the only way to know for sure.

In preparation for the procedure, a patient fasts for eight hours to prevent food in the small intestine from obscuring trouble spots. The patient then swallows the capsule, which encases four tiny flashing lights, a colour camera, a battery and an antenna.

The patient has a receiver taped to his or her abdomen to track the capsule’s progress, recording two images per second. The capsule transmits images via radio frequencies to a Walkman-sized device worn on a belt along with a battery pack.

Two hours after swallowing the M2A capsule, patients can drink clear liquids. At four hours, they can eat solid food. Patients go about their daily business during the eight-hour procedure, careful not to dislodge the receivers or interfere with the battery pack and recorder. Eight hours after swallowing, the patient removes the belt and sensors, and forgets about the small plastic camera.

The following day, the patient returns the belt, battery pack and recorder to the doctor, who downloads the video images into a computer. Software lets the doctor view the entire video of the camera’s journey and save selected images.

The M2A capsule is as cost effective as endoscopy, said Van Dam, and could prevent expensive and painful surgery. Each capsule costs $450 and the one-time software purchase runs under $30,000. ‘It saves money if you consider that these people are bleeding and getting multiple endoscopies and transfusions, or more invasive procedures,’ Van Dam added.