INTRODUCTION

Pill Camera- also known as Capsule Endoscopy. Capsule Endoscopy, is a way to record images of the digestive track for use in medicine. The capsule is the size and shape of a pill and contains a tiny camera. After a patient swallows the capsule, it takes pictures of the inside of the gastrointestinal tract. The primary use of capsule endoscopy is to examine areas of the small intestine that cannot be seen by other types of endoscopy such as colonoscopy. This type of examination is often done to find sources of bleeding or abdominal pain. The procedure was approved by the U.S Food and Drug Administration (FDA). The tiny camera is designed to take high-quality, color pictures in confined spaces. Such a device could find warning signs of esophageal cancer, the fastest growing cancer in the United States. The latest pill camera is sized at 26*11 mm and is capable of transmitting 50,000 color images during its traversal through the digestive system of patient. Video chip consists of the IC CMOS image sensor which is used to take pictures of intestine. The lamp is used for proper illumination in the intestine for taking photos. Micro actuator acts as memory to store the software code that is the instructions. The antenna is used to transmit the images to the receiver. For the detection of reliable and correct information, capsule should be designed to be able to transmit several biomedical signals, such as pH, temp and pressure.

DESCRIPTION

The aim of technology is to make products in a large scale for cheaper prices and increased quality. The current technologies have attained a part of it, but the manufacturing technology is at macro level. The future lies in manufacturing product right from the molecular level. Research in this direction started way back in eighties. At that time manufacturing at molecular and atomic level was laughed about. But due to advent of nanotechnology we have realized it to a certain level. The technology used to achieve manufacturing at molecular level is NANOTECHNOLOGY. Nanotechnology is the creation of useful materials, devices and system through manipulation of such miniscule matter (nanometer). Nanotechnology deals with objects measured in nanometers. Nanometer can be visualized as billionth of a meter or millionth of a millimeter or it is 1/80000 width of human hair. One such product manufactured is PILL CAMERA, which is used for the treatment of cancer, ulcer and anemia. It has made revolution in the field of medicine. "Our goal is to develop this capsule so that it could be used to deliver images in real time, and allow clinicians to make a diagnosis during a single procedure with little discomfort or risk to the patient," said Noby Hata, a researcher in the Department of Radiology at BWH and leader of the development team for the endoscopic capsule. "Ideally, in the future we would be able to utilize this technology deliver drugs or other treatments, such as laser surgery, directly to tumors or injuries within the digestive track." BWH researchers Hata and his colleague, Peter Jakab, have successfully tested a prototype of their capsule in an MRI machine and proved that the capsule can be manipulated to

"swim" through a tank of water. The next step in their research is to successfully test the capsule inside a human body. There is no reason to believe the capsule would move differently in a human than it does in a tank of water. Like the film Fantastic Voyage, physicians at NewYork -Presbyterian Hospital Weill Cornell Medical Center can now take a journey through a patient's body. They aren't inside a miniaturized submarine but rather watching images taken by a tiny camera inside a pill-like device that is swallowed by the patient. The procedure, called capsule endoscopy, has proven to be effective in aiding diagnosis of previously undetectable abnormalities in the small intestine that commonly result in gastrointestinal bleeding. Unexplained abdominal pain or bleeding, if left untreated, may be life-threatening and require hospitalization, said Dr. Felice Schnoll -- Sussman, Assistant Professor of Medicine at Weill Cornell Medical College and Assistant Attending Physician at NewYork -- Presbyterian Weill Cornell. In the past, diagnosis of a patient's small intestine was only possible with traditional endoscopy, small bowel x-rays, or open surgery. Capsule endoscopy is a much improved technique, allowing us to literally shed light on previously hidden areas of anatomy and it is exceptionally safe and convenient for the patient. The FDA-approved device has been shown through numerous studies to be safe and effective. When administered, the capsule glides smoothly through the patient's digestive tract, is naturally excreted, and disposed of. The device, slightly larger than an antibiotic pill, contains a color-imaging camera, a transmitter, and four light-emitting diodes. The patient wears a data recorder around his waist; the recorder stores images that are later downloaded and viewed by the physician. While worn, the data

recorder is inconspicuous enough to allow patients to continue everyday activities such as work, shopping, even eating. Patients with severe small intestinal bleeding are often hospitalized and may require a blood transfusion. In order to determine the source of the bleeding, patients are commonly given a standard endoscopy and colonoscopy but these procedures will not reveal bleeding in the small intestine. Capsule endoscopy is a noninvasive and highly effective way to locate bleeding in the small intestine rapidly, allowing for a proper diagnosis and appropriate treatment. As many as ten percent of gastrointestinal bleeding cases are thought to occur in the small intestine. Capsule endoscopy is especially useful when other methods of diagnosis are unable to detect an abnormality, such as a lesion in the intestinal wall. Another advantage to the non-invasive procedure is that it does not require anesthesia or a bowel preparation. Dr. Schnoll-Sussman is currently enrolling patients for a study that will examine capsule endoscopy for the diagnosis of precancerous growths in individuals with familial adenomatous polyposis, a genetic syndrome that carries an increased tendency towards polyp formation in the small bowel. Capsule endoscopy will be compared to a small bowel series, the more-commonly used radiological diagnostic method. In a previous clinical trial, the capsule endoscopy imaging system detected physical abnormalities in 55 percent of patients compared with 30 percent for standard push enteroscopy, a procedure that involves a camera attached to a flexible wand that is inserted through the patient's mouth and guided into the small intestine. The capsule, while ideally suited to the tight passages of the small intestine, is currently not effective for diagnosis in the

stomach or large intestine. The device used is called the M2A, a patented technology from Given Imaging, Inc., of Norcross, Georgia.

2.1 Conventional Method: Currently, standard method of detecting abnormalities in the intestines is through endoscopic examination in which doctors advance a scope down into the small intestine via the mouth. However, these scopes are unable to reach through all of the 20feet long small intestine, and thus provide only a partial view of that part of the bowel. With the help of pill camera not only can diagnoses be made for certain conditions routinely missed by other tests, but disorders can be detected at an earlier stage, enabling treatment before complications develop. With current endoscopic capsule technology, the capsule tumbles randomly through the digestive track and clinicians have no control over what areas of the body are being

photographed. The ability to steer a capsule, aim a camera, and take pictures of specific areas of concern is a major leap forward with the potential for broad medical implications.

? The pill camera task aims to demonstrate how developments in one field (photography and digital recording or physics and engineering) can be applied to other areas e.g. medicine (making doctors and patients lives easier).

Telemetric gastrointestinal capsule imaging (also referred to as the camera pill or wireless capsule endoscopy) is a noninvasive diagnostic imaging system for use in viewing the esophagus or gastrointestinal (GI) tract, especially the small bowel, which is not accessible to standard upper endoscopy and colonoscopy. A small capsule (approximately 11 26 mm) is swallowed and moves through the GI tract via peristalsis, capturing video pictures which are transmitted to sensors taped to the body and stored on a portable recorder. The strength of the signal is used to calculate the position of the capsule as it passes through the GI tract. Video images are stored on a portable recorder and later downloaded to a computer, from which they may subsequently be viewed in real time. The capsule passes naturally from the body with the stool and, being disposable, is not recovered. Its a vitamin pill-sized camera that could travel through human body taking pictures, helping diagnose a problem which doctor previously would have found only through surgery. A capsule camera is 28 mm (about an inch) long and 11 mm wide. It has a slippery coating when wet to ease swallowing a bit. The cost of the camera and procedure is about $500 (without insurance). The device, called the given Diagnostic Imaging System, comes in capsule form and contains a camera, lights, transmitter and batteries. The capsule has a clear end that allows the camera to view the lining of the small intestine. Capsule endoscopy consists of a disposable video camera encapsulated into a pill like form that is swallowed with water. The wireless camera takes thousands of high-quality digital images within the body as it passes through the entire length of the small intestine. The latest pill camera is sized at 26*11 mm and is capable of

transmitting 50,000 color images during its traversal through the digestive system of patient. Video chip consists of the IC CMOS image sensor which is used to take pictures of intestine. The lamp is used for proper illumination in the intestine for taking photos. Micro actuator acts as memory to store the software code that is the instructions. The antenna is used to transmit the images to the receiver. For the detection of reliable and correct information, capsule should be able to transmit several biomedical signals, such as pH, temp and pressure.

2.3 When Is It Done?

Capsule endoscopy may be done when small bowel disease like celiac or Crohns disease or bowel bleeding that cannot be detected by upper endoscopy or colonoscopy is suspected. Capsule endoscopy can be done in a patient after 10 years of age, including pregnant women.

2.4 Preparation:
In days before the test one will have an appointment with his or her gastroenterologist to discuss about symptoms, gastrointestinal diseases and surgeries he/she has had so far, eventual allergies and medications he/she is taking. Tell the doctor of the presence of a pacemaker or defibrillator, previous abdominal surgery, or previous history of bowel obstructions in the bowel, inflammatory bowel disease, or adhesions. Patient

will probably need to discontinue some medications for some time before and during the test. Patient will need to fast completely (not eat and drink) for 12 hours before the start of the test. 2.5 Procedure: Patient will get a belt with a recorder to wear it around his/her waist. He/she will swallow a camera that will enter his/her bowel and take over 50,000 pictures of the inside layer (mucosa) of his/her small intestine. Pictures will be continuously sending via wireless route (radio waves) to the recorder for 8 hours. Patient will not be allowed to run or exercise during this time but will be able to freely walk around. Two hours after swallowing the camera, patient will be allowed to start to drink and after four hours to eat. When the camera will enter the large intestine it will still take some time (12 to 72 hours but usually within 24 hours after swallowing) to be excreted with the stool. Patient will not need to return a camera to the doctor.

2.6 Working:
It is slightly larger than normal capsule. The patient swallows the capsule and the natural muscular waves of the digestive tract propel it forward through stomach, into small intestine, through the large intestine, and then out in the stool. It takes snaps as it glides through digestive tract twice a second. The capsule transmits the images to a data recorder, which is worn on a belt around the patient's waist while going about his or her day as usual. The physician then transfers the stored data to a computer for processing and analysis. The complete traversal takes around eight hours and after it has completed taking pictures it comes out of body as excreta.

The capsule is designed to be swallowed like a pill and can be equipped with a camera. Once inside the patient's digestive track, a doctor can "steer" the capsule through the body using an MRI machine, photograph specific areas of interest, and view those pictures wirelessly. What makes this system uniquely smaller than other pill cameras is that the whole system, including the laser light used to illuminate the scene, uses just the one fiber optic tube. It vibrates 11-thousand times per second, creating concentric circles of laser light. The light sensor picks-up the light a pixel at a time, and then they're assembled into a complete image by the computer. Everything happens so quickly that the new scope produces 30 pictures a second, the same number of images a TV camera produces. Once swallowed, an electric current flowing through the UW endoscope causes the fiber to bounce back and forth so that its lone electronic eye sees the whole scene, one pixel at a time. At the same time the fiber spins and its tip projects red, green and blue laser light. The image processing then combines all this information to create a two-dimensional color picture. In the tested model the fiber swings 5,000 times per second, creating 15 color pictures per second. The resolution is better than 100 microns, or more than 500 lines per inch. Although conventional endoscopes produce images at higher resolution, the tethered-capsule endoscope is designed specifically for lowcost screening. The system is so simple Dominitz says, "It could potentially be performed by a health technician rather than a physician, where a physician would review the results." That's underscored with today's demonstration where Seibel is both technician and patient.

Study results showed that the camera pill was safe, without any side effects, and was able to detect abnormalities in the small intestine, including parts that cannot be reached by the endoscope.

2.7 Components of a Pill Camera:

2.7.1 Circuit Block Diagram of Transmitter & Receiver:

In the first block diagram, one SMD type transistor amplifies the video signal for efficient modulation using a three biasing resistor and one inductor.

In the bottom block, a tiny SAW resonator oscillates at 315 MHZ for modulation of the video signal. This modulated signal is then radiated from inside the body to outside the body. For Receiver block diagram a commercialized ASK/OOK (ON/OFF Keyed) super heterodyne receiver with an 8-pin SMD was used. This single chip receiver for remote wireless communications, which includes an internal local oscillator fixed at a single frequency, is based on an external reference crystal or clock.

The decoder IC receives the serial stream and interprets the serial information as 4 bits of binary data. Each bit is used for channel recognition of the control signal from outside the body. Since the CMOS image sensor module consumes most of the power compared to the other components in the telemetry module, controlling the ON/OFF of the CMOS image sensor is very important. Moreover, since lightning LEDs also use significant amount of power, the individual ON/OFF control of each LED is equally necessary. As such the control system is divided into 4 channels in the current study. A high output current amplifier with a single supply is utilized to drive loads in capsule.

2.7.2 External Control Unit:

A schematic of the external control circuit unit is illustrated below, where the ON/OFF operation of the switch in the front of the unit is encoded into 4 channels Control signals. These digital signals are then transferred to a synthesizer and modulated into an RF signal using an OOK transmitter with a carrier frequency of 433 MHz. To verify the operation of the external control unit and telemetry capsule, CH1 was used to control ON/OFF of CMOS image sensor and CHs 2-4 to control lighting. The four signals in front of the control panel were able to make 16different control signals (4 bit, 2^4 = 16).The bi-directional operation of telemetry module is verified by transmitting video signal from CMOS image sensor image data was then displayed.

The proposed telemetry capsule can simultaneously transmit a video signal and receive a control determining the behavior of the capsule. As a result, the total power consumption of the telemetry capsule can be reduced by turning off the camera power during dead time and separately controlling the LEDs for proper illumination in the intestine. Accordingly, proposed telemetry module for bidirectional and multi-channel

communication has the potential applications.

2.8 Internal View of a Pill Camera:

It has 8 parts: Optical Dome Lens Holder Lens Illuminating LEDs

 CMOS Image Sensor Battery ASIC Transmitter Antennae

Optical Dome:

 This shape results in the easy orientation of the capsule axis along the central axis of small intestine and so helps propel the capsule forward easily. The Optical Dome contains the Light Receiving Window.

Lens Holder:

The Lens Holder is that part of the capsule which accommodates the lens. The lens is tightly fixed to the holder so that it doesnt get dislocated anytime.

Lens:

The Lens is an integral component of the capsule. It is arranged behind the Light Receiving Window.

Illuminating LEDs:

Around the Lens & CMOS Image Sensor, four LEDs (Light Emitting Diodes) are present. These plural lighting devices are arranged in donut shape.

CMOS Image Sensor:

CMOS (Complementary Metal Oxide Semiconductor) Image Sensor is the most important part of the capsule. It is highly sensitive and produces very high quality images. It has 140 degree field of view and can detect object as small as possible.

Battery:

 Battery used in the capsule is buttons shaped and are two in number as shown. The batteries are arranged together just behind the CMOS Image Sensor. Silver Oxide primary batteries are used (Zinc/Alkaline Electrolyte/Silver Oxide). Such a battery has an even discharge voltage, disposable and doesnt cause harm to the body. ASIC Transmitter: The ASIC (Application Specific Integrated Circuit) Transmitter is arranged behind the Batteries as shown. Two Transmitting Electrodes are connected to the outlines of the ASIC Transmitter. These electrodes are electrically isolated from each other.

Antennae:

As shown, the Antennae are arranged at the end of the capsule. It is enclosed in a dome shaped chamber.

2.9 Uses of Pill Camera:

Capsule endoscopy is used to examine parts of the gastrointestinal tract that cannot be seen with other types of endoscopy. Upper endoscopy, also called EGD, uses a camera attached to a long flexible tube to view the esophagus, the stomach and the beginning of the first part of the small intestine called the duodenum. A colonoscope, inserted through the rectum, can view the colon and the distal portion of the small intestine, the terminal ileum. Capsule endoscopy is useful when disease is suspected in the small intestine and can sometimes diagnose sources of occult bleeding (blood visible

microscopically only) or causes of abdominal pain such as Crohns disease, or peptic ulcers. Capsule endoscopy is also used in the medication related to Small Bowel Injury. Capsule endoscopy can be used to diagnose problems in the small intestine, but unlike EGD or colonoscopy, cannot treat pathology that may be discovered. The capsule endoscopy can use Bluetooth to transfer the captured images.

Advantages of Pill Camera:

It's a non-invasive, safe test. Painless, no side effects. Miniature size so can move easily through the digestive system. Accurate, precise and effective. Images taken are of very high quality which can be sent almost instantaneously to the data recorder for storage. Made of bio-compatible material, doesnt cause any harm to the body.

2.11 Complications, Drawbacks & Overcomes:

It is a revolution, no question about it but the capsule poses medical risks. However, the complications of capsule endoscopy are rare: Unfortunately, patients with gastrointestinal structures or narrowing are not good candidates for this procedure due to the risk of obstruction". It might also happen that the pill camera might not be able to traverse freely inside digestive system, which may cause the tests to be inconclusive. This drawback can be overcome using another product manufactured with the help of nanotechnology which is the rice- grain sized motor.

 Capsule can stuck at a narrowed spot in the digestive tract resulting in bowel obstruction. This usually relates to a stricture (narrowing) of the digestive tract from inflammation, prior surgery, or tumor. Its important to recognize obstruction early. Signs of obstruction include unusual bloating, abdominal pain, nausea or vomiting. One should call his/her doctor immediately for any such concerns. Also, if he/she develops a fever after the test, have trouble swallowing or experience chest pain, inform the doctor immediately. Be careful not to prematurely disconnect the system as this may result in loss of pictures being sent to your recording device. The procedure is considered low-risk, but there is a chance of the capsule becoming lodged in the digestive tract. That's thought to happen about one percent of the time; in some cases, the capsule has to be removed with a scope or through surgery. They only allow a single fly-by view. The next big challenge is to make this cheaply. The pill camera can transmit image from inside to outside the body. Consequently it becomes impossible to control the camera behavior, including the on/off power functions and effective illuminations inside the intestine. These two drawbacks can be overcome using a Bi-directional telemetry Camera.

 FUTURE ASPECTS
The researchers are working on several improvements, including: Until recently, only the proximal (esophagus, stomach and duodenum) and the distal (colon) portions of the gastrointestinal tract were easily visible using available technology. The twenty feet or so of small intestine in between these two portions was essentially unreachable. This hurdle might soon be overcome.

 Being able to move the camera wirelessly so it can 'look around' while the pill makes its way down the digestive tract. Software that can scan each set of images automatically and alert doctors; currently, scans must be done manually by a doctor or technician. Better image resolution so that finer objects such as blood vessels can be clearly seen. In the future, researchers hope to not only take pictures, but also to 'tag' diseased locations, deliver treatments, and even use the capsules for weight management by inflating them like a balloon inside the stomach so that the person feels full. They aim to halve the cost of the capsule too.

CONCLUSION
The given Endoscopy capsule is a pioneering concept for Medical Technology of the 21st century.This endoscopy system is the first of its kind to be able to provide non-invasive imaging of the entire small intestine.It has revolutionized the field of diagnostic imaging to a great extent and has proved to be of great help to physicians all over the world. The drawbacks of Pill Camera will also overcome soon.

BIBLIOGRAPHY & REFERENCES

www.scribd.com www.sciencedaily.com

www.sciencecentral.com www.reuters.com www.seminarprojects.com www.seminarsonly.com Capsule endoscopy Wikipedia, the free encyclopedia