Pill-sized camera aids in diagnosis

Staff Report

Patients of the U.Va. Health System may benefit from a new medical device that allows physicians to view the entire length of the small intestine using a tiny camera — compact enough to be contained in an easily swallowed capsule, but sensitive enough to offer a major improvement over existing technology.

U.Va.’s Digestive Center of Excellence has begun using the M2A capsule that views the entire length of the small intestine, an advancement over the traditional push enteroscope that examines only the top one-third.

Recent evaluations suggest that this new technology may be 70 percent more sensitive than traditional enteroscopy for the detection of small-bowel abnormalities and may provide 12 times the diagnostic ability of a radiologic series or X-rays, according to the journal Gastroenterology and Endoscopy News.

“This camera has the potential to revolutionize the way we diagnose intestinal bleeding,” said Dr. Fabio Cominelli, an internal medicine professor and director of the digestive center.

The Given Diagnostic Imaging System, developed by Given Imaging of Israel, consists of the video capsule, a data recorder and a processing workstation. The capsule, the size of a large multi-vitamin pill, contains a tiny disposable color video camera and transmitter, which passes through the digestive tract and is excreted naturally. The camera transmits two images per second to the data recorder that patients wear around the waist as they continue their daily activities.

After about eight hours, the patient returns to the clinic, where the data is downloaded into the workstation for the physician to evaluate.

The U.S. Food and Drug Administration approved the Given system in August. The FDA noted in a trial of 20 patients, the system detected abnormalities in 60 percent of patients, compared to the 35 percent detection rate of traditional enteroscopy. The FDA also noted that this system identified sources of bleeding in five cases that were beyond the reach of the enteroscope. All patients in the trial had suspected small intestine disorders and had previously undergone multiple gastrointestinal endoscopies and radiological procedures to identify the source of their small intestine disorders, without a conclusive diagnosis.