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CHAPTER 1 INTRODUCTION

The advancement of our technology today has lead to its effective use and Application to the medical field. One effective and purposeful application of the Advancement of technology is the pr ocess of endoscopy, which is used to diagnose and examine the conditions of the gastrointestinal tract of the patents. It has been reported that this process is done by

inserting an 8mm tube through the mouth, with a camera at one end, and images are shown on nearby monitor, allowing the medics to carefully guide it down to the gullet or stomach. However, despite the effectiveness of this process to diagnose the patients, research shows that endoscopy is a pain stacking process not only for the patients, but also for the doctors and nurses as well. From this, the evolution of the wireless capsule endoscope has emerged. Reports, that through the marvels of miniaturization, people with symptoms that indicate a possible in the gastrointestinal tract can now swallow a tiny camera that takes snapshots inside the body for a physician to evaluate. The miniature e camera, along with a light, transmitter, and batteries, called Capsule Cam, is housed in a capsule, the size of a large vitamin pill, and is used in a procedure known as capsule endoscopy, which is a noninvasive and painless way of looking into the esophagus and small intestine. Once swallowed, the capsule is propelled through the small intestine by peristalsis, and acquires and transmits digital images at the rate of two per second to a sensor array attached to the patients abdomen, through a recording device worn on a belt stores the images, to be examined and reviewed.

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CHAPTER 2 HISTORY AND DEVELOPMENT
EUS endoscopes are unique because they offer ultrasound guided needle biopsy, colour Doppler and advanced image. The technology available to doctors has evolved dramatically over the past 40 years, enabling specially trained gastroenterologists to perform tests and procedures that traditionally required surgery or were difficult on the patient.

Fig .2.1: EUS endoscope "Basic endoscopy was introduced in the late 1960s”, and about 20 years later, ultrasound was added, enabling us to look at internal GI structures as never before. Now, with EUS ,we can determine the extent to which tumours in the esophagus, stomach, pancreas, or rectum have spread in a less invasive way. In addition to using an endoscope to stage tumours, gastroenterologists can use the instrument to take tissue samples with fine needle aspiration(FNA). The endoscope, specially equipped with a biopsy needle, is guided to a specific site and extracts a tissue sample. One technology that has been available for about 30 years, Endoscopic Retrograde Cholangio- pancreatography (ERCP),combines X-rays and endoscopy to diagnose conditions affecting the liver, pancreas, gallbladder, and the associated ducts. An endoscope is guided down the patient's esophagus, stomach, and small intestine, and dye is
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attaches a small capsule to the wall of the esophagus. and in certain medical centers. A newer alternative eliminates the catheter completely. there could be a motility problem. and obtain biopsy samples. the catheter is attached to a special monitor. "Manometry" is a specialised test that gastroenterologists use to record muscle pressure within the esophagus or anorectal area. the failure of the lower esophageal sphincter muscle to relax. 3 . I instead. When a person has difficulty in swallow ing food or excreting waste.injected to tiny ducts to enhance their visibility on X-ray. remove difficult bile duct stones. such as University Hospital's Therapeutic Endoscopy and GI Mobility Center. essential information for the diagnosis of esophageal disorder such as achalasia. it is used to place stents within bile ducts. afterward. the gastroenterologist. and problem such as fecal incontinence or constipation- related rectal outlet obstruction. using an endoscope. ERCP's role has expanded. The capsule transmits signals to a special receiver. which is worn by the patient for 24 hours. Motility is the movement of food from one place to another along the digestive tract. The traditional pH test involves threading a catheter into the patient's nose and down the throat. the data is downloaded to a computer at the doctor's office.

These pictures are send to recording device. Fig. 4 .CHAPTER 3 UNDERSTANDING CAPSULE ENDOSCOPY Capsule Endoscopy lets the doctor to examine the lining of the gastrointestinal tract.000 high quality images. jejunum. It produces two frames per second with an approximate of 56.1: A capsule in view Doctor will be able to view these pictures at a later time and might be able to provide useful information regarding a human’s small intestine. A pill sized video camera is given to swallow. Capsule endoscopy helps the doctor to evaluate the small intestine. The most common reason for doing capsule endoscopy is to search for a cause of bleeding from the small intestine. which has to wear on the body. ulcer s and tumors of the small intestine.3. inflammatory bowel disease (Crohn’s disease) . It may also be useful for detecting polyps. which includes the three portion of the small intestine(duodenum. This camera has its own light sour ce and take picture of small intestine as it passes through. This part of the bowel cannot be reached by traditional upper endoscopy or by colonoscopy. and ileum).

The white. The silver oxide batteries in the capsule power the CMOS detector. There are three vital technologies that made the tiny imaging system possible: improvement of the signal-tonoise ratio (SNR) in CMOS detectors.light LEDs are important because pathologists distinguish diseased tissue by colour. Synchronous switching of the LEDs. small size and power efficiency are important. The system’s computer work station is equipped with software for reviewing the camera data using a variety of diagnostic tools. The developers provided a novel optical design that uses a wide-angle over the imager. efficiency. as well as the LEDs and transmitter. the CMOS sensor. This allows physicians choice of viewing the information as either streaming or singl 5 . and ASI C transmitter minimizes the power consumptions. Recent advances in ASIC design allowed the integration of a video transmitter of sufficient power output. and manages to integrate both the LEDs and imager under one dome while handling stray light and reflections. and band width of very small size into the capsule.CHAPTER 4 ARCHITECTURAL DESIGN `Fig.1: Wireless capsule endoscope For this application.4. development of white LEDs and development of application.specific integrated circuits(ASI Cs).

Lenses are tightly fixed in the capsule to avoid dislocation of lens. Optical Dome. Antenna. 7. Battery. Optical dome is the light receiving window of the capsule and it is a non. 6 . 4.4. 2.2: Internal view of a capsule The figure shows the internal view of the pill camera. 4. Illuminating LEDs. Lens Holder. Lens. CMOS Image Sensor. 6. ASICTransmitter 8.1. 3. 4. 5.2 LENS HOLDER: This accommodates the lens. It has 8 parts: 1.1 OPTICAL DOME: It is the front part of the capsule and it is bullet shaped.4. It prevents the filtration of digestive fluids inside the capsule.1 INTERNAL VIEW OF THE CAPSULE: Fig.1.conductor material.

The light through window falls on the lens. 4.4.8 ANTENNA: Parylene coated on to polyethylene or polypropylene antennas are used. It is disposable and harmless material.4 ILLUMINATING LEDs: Illuminating LEDs illuminate an object. 4.1.1mm.1.1. 4. Two transmitting electrodes are connected to this transmitter and these electrodes are electrically isolated. Antenna received data from transmitter and then sends to data recorder.1.6 BATTERY: Battery used in the pill camera is bullet shaped and two in number and silver oxide primary batteries are used. Light irradiated from the LED s pass through the light receiving window. It have high precise.1.7 ASIC TRANSMITTER: It is application specific integrated circuit and is placed behind the batteries.5 CMOS IMAGE SENSOR: It have 140 degree field of view and detect object as small as 0. 4.1. 7 . Non reflection coating id placed on the light receiving window to pr event the reflection. 4.3 LENS: It is the integral component of pill camera. This lens is placed behind the Optical Dome.

2 PILL CAMERA PLATFORM COMPONENTS: In or der for the images obtained and transmitted by the capsule endoscope to be useful. Sensor Array Belt. Work Station and Rapid Software. 4. Mainly there are 5 platform components: 1. The antenna array and battery pack cam be worn underregular clothing. 8 . as dictated by a template for lead placement. 2. 5. worn in standard locations over the abdomen. Real Time Viewer. Pill cam Capsule -SB or ESO. endoscopy examination takes approximately 7 hours. they must be received and recorded for study. The recording device to which the leads are attached is capable of recording the thousands of images transmitted by the capsule and received by the antenna array. The antenna array is very similar in concept and practice to the multiple leads that must be affixed to the chest of patients undergoing standard lead electrocardiography. Data Recorder.4. Patients undergoing capsule endoscopy bear an antenna array consisting of leads that are connected by wires to the recording unit. 3. Ambulary (non-vigorous) patient A typical capsule movement does not interfere with image acquisition and recording.

2. Two sided imaging. One side imaging. Table 4. 2. Automatic lighting control.000 images in 8 hours.2 SENSOR ARRAY BELT: Fig.4.3: Sensor array belt 9 . 4. 50.2.600 images in 20 minutes.1 PILL CAMERA CAPSULE:-SB OR ESO SB Approved by Food and Drug Administration. Standard lighting control.2.1 types of capsules. For esophagus. 14 images per second. ESO Approved b y Food and Drug Administration. For small bowel.4. Two images per second.

2. Do not expose them to shock. Sensor arrays are used to calculate and indicate the position of capsule in the body.4: Data recorder The Date Recorder stores the images of your examination. 10 . Sensor Array and Battery Pack carefully. attached to the sensor belt. It is of the size of walkman and it receives and stores 5000 to 6000 JPEG images on a 9 GB hard drive. These wires are connected to a light weight data recorder worn on a belt. data cable. Handle the Date Recorder.3 DATA RECORDER: Data recorder is a small portable recording device placed in the recorder pouch. vibration or direct sunlight. do not pull the leads off the Sensor Arr ay! Peel off each adhesive sleeve starting with the non adhesive tab without removing the sensor from the adhesive sleeve. Sensors are incorporated within the belt.4.Several wires are attached to the abdomen like ECG leads to obtain images by radio frequency. Parts of sensor array are sensor pads. which may result in loss of information. Fig. A patient receiver belt around his or her waist over clothing. A belt is applied around the waist and holds a recording device and a batter y pack. and receiver bag. Data recorder receives and records signals transmitted by the camera to an array of sensors placed on the patients body. Return all of the equipment as soon as possible. Place the Sensor Array with the rest of the equipment. battery charging. Recorder Belt. To remove the Sensor Array from your abdomen. It has light weight (470 gm). Images takes several hours to download through several connection. 4.

4.4.2. 11 .5: Real time viewer It is a handheld device and it enables real-time viewing.4 REAL TIME VIEWER: Fig. It contains rapid reader software and colour LCD monitor. It test the proper functioning before procedures and confirms location of capsule.

Another new addition to the software package automatically highlights capsule images that correlates with the existence of suspected blood or red areas. to view it in both forward and reverse directions. It helps to convert images in to a movie and allows the doctor to view the colour 3D images.4. The recording device is then attached to a specially modified computer workstation. where it becomes available to the physician as a digital video. the antenna array and image recording device are returned to the health care provider. 12 . Once the patient has completed the endoscopy examination. A recent addition to the software package is a feature that allows some degree of localization of the capsule within the abdomen and correlation to the video images.2. and to capture and label individual frames as well as brief video clips.5 WORKSTATION AND RAPID SOFTWARE: Rapid workstation per forms the function of reporting and processing of images and data. I mage data from the data recorder is downloaded to a computer equipped with software called rapid application software. I mages showing normal anatomy of pathologic findings can be closely examined in full colour. and the entire examination is downloaded in to the computer. The workstation software allows the viewer to watch the video at varying rates of speed.

Infidel frames and video clips of normal or pathologic findings can be saved and exported as electronic files for incorporation into procedure reports or patient records. At this point. The examination can be considered complete. once the indicator lights on the c Capsule and recorder show that data is being transmitted and received. the capsule is swallowed with a small amount of water. and the patient can return the antenna array and recording device to the physician. After a careful medical examination the patient is fitted with the antenna array and image recorder.CHAPTER 5 THE CAPSULE ENDOSCOPY PROCEDURES A typical capsule endoscopic procedures begins with the patient fasting after midnight on the day before the examination. Interpretation of the study takes approximately 1 hour. A fully charged capsule is removed from its holder. Download of the data in the recording device to the workstation takes approximately 2.5 to 3 hours. 13 . the patient is free to move about. and hyper and hypo motility states affect the free-floating capsule’s transit rate through the gut. The recording device and its battery pack are worn on a special belt that allows the patient to move freely. It should be noted that gastrointestinal motility is variable among individuals. surfactant (eg: simethicone) may be administered prior to the examination to enhance viewing. Patients should avoid ingesting anything other than clear liquids for approximately two hours after capsule ingestion (although medications can be taken with water). Seven to 8 hours after ingestion. Patients can eat food approximately 4 hours after they swallow the capsule without inter fearing with the examination. however. No formal bowel preparation is required.

and determine whether implanted cardiac devices had any effect on the image capture by capsule endoscopy. 14 . and reported that capsule endoscopy is useful for evaluation of suspected Crohn’s disease.CHAPTER 6 RESEARCHES One research suggests that . To put it simply. and give importance to the value and efficiency of using the capsule endoscope as a way of evaluating the existing gastrointestinal diseases of patients. The third study also evaluates the potential of capsule endoscopy. who were being assessed for obscure gastrointestinal bleeding. has no side effects. Thus. Another research by supports this claim. with the use of capsule endoscopy. related enteropathy and celiac disease. and conducts a research to evaluate its safety in patients with implanted cardiac devices. emphasize that the use of capsule endoscopy is safe. such as obscure gastrointestinal bleeding(OGB) and Crone’s disease. All of the three research studies were able to effectively convey their message and aim. certain gastrointestinal diseases were diagnosed from a number of patients in a hospital. effective. and implanted cardiac devices do not appear to interfere with video capsule imaging. and is efficient in the careful diagnosis and treatment of the patients. and is believed useful in investigating and guiding further management of patients suspected with the identified diseases. The researches were done by letting the participants swallow the capsule endoscope for the physicians to examine and assess the conditions of their gastrointestinal tract by the image captured by the capsule endoscope. the three researches conducted. study concludes that capsule endoscopy was not associated with any adverse cardiac events. and is helpful in assessment of small bowel disease of children.

for the use of the traditional endoscope does not only damage the gastrointestinal tract of the patients but affects also the patients and the hospital staffs because of the pain stacking process.This process does not only help to detect the severity of the existing gastrointestinal disease but also determine its effective to the presence of implanted cardiac devices. The researchers also emphasized that the use of the capsule endoscope is better than using the traditional endoscope. 15 .

Simple procedure.  It is very expensive and not reusable. normal endoscopy. Harmless material. 16 .2 DISADVANTAGES:  Gastrointestinal obstructions prevent the free flow of capsule. Avoids risk in sedation. cannot be stopped or steered to collect close-up details.  It cannot be controlled once it has been ingested.  It is not a replacement for any existing GI imaging technique. pregnant women face difficulties. PILL-CAMERA)          Painless.e. Miniature size. no side effects. Efficient than X-ray CT-scan. High quality images. 7.  It cannot be used to take biopsies.  Capsule endoscopy does not replace standard diagnostic endoscopy. High sensitivity and specificity.CHAPTER 7 ADVANTAGES& DISADVANTAGES 7. apply therapy or mark abnormalities for surgery.  Patients with pacemakers. precise (view of 150 degree). Accurate.1 ADVANTAGES: Advantage of this bio-capsule is (i. generally performed after a standard endoscopy and colonoscopy.

celiac disease. barreff’s esophagus.  Pill cam ESO can detect esophageal diseases. gastrointestinal reflex diseases.  Pill cam SB can detect Crohn’s disease. 17 .  Nano robots perform delicate surgeries. ulcerative colitis etc.CHAPTER 8 APPLICATIONS Applications of this PILL-CAMERA are below  Biggest impact in the medical industry. small bowelinjury. small bowel tumours.

esophageal and gastric capsules will improve in quality. Therapeutic capsules will emerge with brushing. eroding the supremacy of flexible endoscopy.time imaging. and become embedded into screening programs. The main pressure is to reduce the component size. The continued reduction in size. External wireless commands will influence capsule diagnosis and therapy and will increasingly entail the use of real. However. cytology. biopsy and drug deliver y capabilities.CHAPTER 10 FUTURE SCOPE& CONCLUSION 10. and immunologic cancer recognition. Diagnostic capsules will integrate physiological measurements with imaging and optical biopsy. The image quality is not bad but needs to be improved if it is to become a realistic substitute for flexible upper and lower gastrointestinal endoscopy. depth of field. Colonic. which will release space that could be used for 18 . An increase in the frame rate. The current differences are becoming blurred and hybrids are emerging. increases in pixel numbers and improvements in imaging with the two rival technologies-CCD and CMOS is likely to change the nature of endoscopy. duration of the procedure and improvements in illumination seem likely. Electrocautery may also become possible. angle of view. Double imager capsules with increased frame rates have been used to image the esophagus for Barrett’s and esophageal varies. This will be attractive to patients especially for cancer or varies detection because capsule endoscopy is painless and is likely to have a higher take up rate compared to conventional colonoscopy and gastro copy. especially CMOS chip technology. fluid aspiration.1 FUTURE SCOPE: It seems likely that capsule endoscopy will become increasingly effective in diagnostic gastrointestinal endoscopy. image numbers. it should be noted that speculations about the future of technology in any detail are almost always wrong. The development of the capsule endoscopy was made possible by miniaturization of digital chip camera technology. Remote control movement will improve with the use of magnets and or electro stimulation and perhaps electromechanical methods.

One limitation to therapeutic capsule endoscopy is the low mass of the capsule endoscope. propulsion methods and therapy including tissue coagulation. coagulation or therapy. A force exerted on tissue for example by biopsy forceps may push the capsule away from the tissue.other capsule functions such as biopsy. the nature of lasers which have typical inefficiencies of 100-1000 per cent makes the idea of a remote laser in a capsule capable of stopping bleeding or cutting out at umour seems to be something of a pipe dream at present. These acronyms stand for: VECTOR = Versatile Endoscopic Capsule for gastrointestinal Tumour Recognition and therapy and NEMO = Nano-based capsule-Endoscopy with Molecular Imaging and Optical biopsy. miniature actuators and even motors into capsule endoscopes are being developed. Narrow band imaging and immunologically or chemically targeted optical recognition of malignancy are currently being explored by two different groups supported by the European Union as FP6 projects: -the VECTOR and NEMO projects. Small motors are currently available to move components such as biopsy devices but need radio. biopsy and cytology. New engineering methods for constructing tiny moving parts. Future diagnostic developments are likely to include capsule gastro copy.conductor lasers that are small enough to swallow are available. and the size to capacity ratio of some capacitor s has recently been reduced by the use of tantalum. 19 . Although semi.controlled activators. The reason because of doctors rely more on camera pill than other types of endoscope is because the former has the ability of taking pictures of small intestine which is not possible from the other types of tests. The construction of an electrosurgical generator small enough to swallow and powered by small batteries is conceivable but currently difficult because of the limitations imposed by the internal resistance of the batteries. Opening small biopsy forceps to grasp tissue and pull it free will require different solutions to those used at flexible endoscopy-the push force exerted during conventional biopsy is typically about 100 g and the force to pull tissue free is about 400 g. because of power requirements. attachment to the gut wall. ultrasound imaging. It may be possible to store power in small capacitors for end surgical use.

in the proper context. ulcers) seems ideally suited for this particular role. not all abnormal findings encountered are the source of patient’s problem.2 CONCLUSION: Wireless capsule endoscopy represents a significant technical breakthrough for the investigation of the small bowel.10. Although a wide variety of indications for capsule endoscopy are being investigated. Capsule endoscopy has the potential for use in a wide range of patients with a variety of illnesses. 20 .diagnose small bowel disease. Still. tumours.g. capsule endoscopy can provide valuable information and assist in the management of patients with difficult –to. other uses for the device should be considered experimental at this time and should be performed in the context of clinical trials. At present. capsule endoscopy seems best suited to patients with gastrointestinal bleeding of unclear etiology who have had non-diagnostic traditional testing and whom the distal small bowel(beyond reach of push enetroscope) needs to be visualized. Care must be taken in patient selection. The ability of the capsule to detect small lesions that could cause recurrent bleeding (e. especially in light of the shortcomings of other available techniques to image this region. and the images obtained must be interpreted approximately and not over read that is.

2009 BioCAS 2009. Accessed October 5 2007. BMJ. doi:10.332.1136/bmj. et al. March 4 2006. 21 . " Gastrointestinal capsule endoscopy: from tertiary centres to primary care". Reena. IEEE [2] Intelligent Systems .528. IEEE Transactions on Dec. Mayo Clinic. 2006 3rd International IEEE Conference on capsule endoscopy [3] Medical Imaging. [5] "Capsule Endoscopy in Gastroenterology". 2008 [4] Sidhu.REFERENCES [1] Biomedical Circuits and Systems Conference.7540. 332:528-531.