Mayo Clinic performs more than 1,000 capsule endoscopy procedures

Tuesday, September 26, 2006

SCOTTSDALE, Ariz. — In August 2001, it could have been mistaken for a scene in a futuristic movie: A human subject swallows a pill-sized camera designed to uncover some kind of mystery.

But now, more than 1,000 "swallows" later at Mayo Clinic in Arizona, the mystery is far less ominous. Instead, the miniature camera is heralded as the best medical imaging device available today for observing the entire small bowel and potentially revealing a previously undiagnosed tumor or bleeding in the digestive tract.

Called video capsule endoscopy, Mayo Clinic in Arizona was one of only three centers in the U.S. to begin doing the procedure in 2001, very shortly after it was approved by the FDA. David Fleischer, M.D., chairman of Gastroenterology at Mayo, has called it "one of the most revolutionary advances in the field of gastroenterology in the last 50 years."

Now Mayo is recognizing the milestone of having performed more than 1,000 such procedures.

Capsule endoscopy involves swallowing a plastic capsule the size of a large vitamin that contains a small, disposable camera that takes pictures of a patient's digestive system. Eight hours later, high-resolution color images are available to physicians that allow unprecedented views of the small intestine and can lead to more accurate diagnoses of conditions such as Crohn's disease, ulcers, polyposis (a condition that can lead to colon cancer) and vascular malformations.

But it's the "getting there" that is intriguing to both patients and physicians. The capsule contains the miniature color video camera, a light, a battery and a transmitter. Once the patient swallows the capsule, simply by taking a glass of water, (no sedation is required) a number of sensors previously attached to the patient's torso begin to record the images captured by the camera. The patient spends the next eight hours (the time it takes for the capsule to move through the small intestine) wearing the recording device and going about his or her normal business.

The data recorder is then removed from the patient and the images downloaded onto a computer. Approximately 50,000 images in all are combined into a movie-like file for the physician to view and interpret. (Just so there is no misunderstanding, the capsule itself is not retrieved by physicians. Instead, it is disposed of through the body's natural elimination process.)

Mayo physicians emphasize that capsule endoscopy is not a substitute for the more traditional gastrointestinal endoscopy, the procedure in which long, flexible tubes with lights are inserted through the mouth, down the throat and into the upper or lower digestive tract.

"Capsule endoscopy is a breakthrough technology because we can look at the entire 30 feet of the small intestine - not just the four to five feet that we can see with other types of endoscopy," says Jonathan Leighton, M.D., Gastroenterology, Mayo Clinic.

In the past year, esophageal capsule endoscopy has been implemented, and the procedure has been found to be beneficial in terms of screening for varices (dilated veins) in patients with chronic liver disease. Mayo is close to performing 100 of those procedures.

Future goals for the capsule would be its development for viewing the stomach and colon. A study to examine the colon is underway and due to begin in the near future.

Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. As a leading academic medical center in the Southwest, Mayo Clinic focuses on providing specialty and surgical care in more than 65 disciplines at its outpatient facility in north Scottsdale and at Mayo Clinic Hospital. The 208-licensed bed hospital is located at 56th Street and Mayo Boulevard (north of Bell Road) in northeast Phoenix, and provides inpatient care to support the medical and surgical specialties of the clinic, which is located at 134th Street and Shea Boulevard in Scottsdale.

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