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Camera provides inside view of intestines

Posted: Monday, September 30, 2002

HOMER (AP) -- At $1,800 a pop, you don't want to take two of these pills and call your doctor in the morning. But taking just one of them could save your life. A physician in the fishing town of Homer is offering the pill.

It's not a vitamin, medicine or herbal remedy. The ''M2A'' is actually a still camera covered in a digestible capsule. Once swallowed, it travels through your digestive system and sends back images from the small intestine.

''It basically gives us access to places we've not been able to go before without pretty invasive surgery,'' said Dr. Rene Alvarez, a Homer general surgeon. ''It fills in the gaps between an upper G.I. endoscopy and a colonoscopy, showing a 21-foot section of the small intestine.''

Patients swallow the single-use camera in the morning. Throughout the day, they wear a belt, which carries a battery pack, a computer hard-drive and a transducer.

Eight sensors attached to the patient's body allow the system to track the camera's progress. It transmits two images per second to the hard drive, which records them. At the end of the day, the camera is passed painlessly in the patient's stool.

Alvarez then downloads the images -- about 50,000 of them. He watches the time-lapse voyage on a computer, looking for irregularities such as bleeding, ulcers, strictures or tumors.

Onscreen, Alvarez sees a high resolution, near-video image of the intestine, as well as a map pinpointing the camera's location. He can isolate segments for closer inspection.

It takes Alvarez about 45 minutes to watch the progress of the camera.

''It really opens doors for us, because in the past, patients would go to doctors with all these complaints about pain or bleeding, and they'd go essentially undiagnosed and get labeled as an irritable bowel.''

If the mystery pain didn't go away on its own, invasive exploratory surgery was the only remaining option.

Now, patients can opt for the easily swallowed camera capsule.

The capsule holds a tiny lens with a 140-degree field of view, two batteries, four LED flashes, an antenna and a transmitter.

The only risk associated with the procedure involves the camera getting stuck in the intestine, which happens about 1 percent of the time.

''If it gets stuck, that usually means there's something wrong, either a tightening or a stricture in the intestine, or a tumor,'' Alvarez said. ''That would have to be operated on anyway.''

The technology has been in the works for about 10 years. It was approved by the federal Food and Drug Administration last year. An Israeli scientist who designed imaging systems for missiles worked on the camera as a side project.

''It's a new technology, and its only going to improve,'' said Alvarez, who has 15 years of experience as a general surgeon in Alaska.

For now, capsule endoscopy is only performed after traditional scoping procedures have been tried.

Early on the morning of Sept. 10, Alvarez watched as his first patient, Dr. Bill Bell of Homer, swallowed the capsule and strapped on the belt.

''Going down wasn't a problem at all,'' Bell said later. ''It went right down. Its pretty slippery, and its not much bigger than a big B vitamin. The belt is getting a lot of questions here at the office, and occasionally I'll sit down and bump it.'' Bell said he agreed to be a guinea pig because he's ''interested in the extension of technology into medicine.''

''The technology is pretty amazing,'' he said. ''For the right clinical situation, from what I've experienced so far, I'd definitely recommend it.''



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