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Interviewees: Eric Seibel, University of Washington; Jason Dominitz, Seattle VA Hospital
A UNIQUE TOUR
Eric Seibel is about to take visitors to his laboratory on a tour down his own throat into his stomach. The University of Washington mechanical engineer is developing a camera small enough you can just swallow it like a pill.
First, he takes a sip of water. “Just whetting the whistle,” he explains. Then, he swallows the capsule and a nearby monitor shows its descent down his esophagus. The capsule is tethered to the outside world by a tube so narrow he’s able to describe what the picture is showing. “Now we’re in the stomach.”
Endoscopes have been providing doctors live images of the esophagus and stomach for years. However, current medicine many hundreds of fiber optic cables bundled into a tube as wide as an adult’s index finger. This new endoscope that the patient can swallow like a pill has a tether or tube that holds just a single illumination optical fiber that is slightly wider than a human hair.
“I’m fine,” Seibel says, adding, “I can talk. It just feels like some piece of spaghetti, cooked spaghetti, hanging down the back of my throat. It’s not a big deal.”
Compare that to today’s procedure where, because of the size of the tube, a patient is typically sedated using intravenous medications and has to have someone drive them home afterwards.
Seibel recently added a second tiny tube to pump air around the camera, which can be used to force open the entry to the stomach or blow away bubbles that might block something doctors want to see.
As is required in research like this, a doctor is supervising. Jason Dominitz of the Veteran’s Administration Puget Sound Health Care System is helping with the medical aspect of the project, and is also helping out with the finer medical points of the “tour.”
Seibel sees a system like this as making it easy for doctors to routinely screen for conditions that can lead to cancer of the esophagus. As with any cancer, early detection is critical in stopping it.
The system is still being developed and Seibel and his team are still making improvements. He’d like to make the fiber optic cable even thinner and find a way to make the entire system less expensive. The camera system would then have to undergo human trials and get Food and Drug Administration approval before doctors could use it.
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 a 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.
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.
Dominitz tells his visitors that a woman who was their first volunteer had no problem with the tethered system, even though she confessed afterwards that she normally can’t swallow pills and has to crush them up.
Because the fiber optic tube is only slightly wider than the size of a human hair, Seibel hopes doctors could eventually steer the camera into places that now require surgery in order to be seen. For example, Seibel says that currently endoscopes can only be used in the central parts of the lung, but that, “we want to get all the way out to the periphery,” which would be helpful in detecting and stopping lung cancer. Additionally, he hopes one day they could snake the camera past the stomach and on into the pancreas, or past the bladder and into the kidney.
The combination of the laser light and the second hollow tube might also turn the device into something that could treat cancer. He says doctors might just get the license to “turn up the laser and just give it (the newly discovered cancer cells) a suntan and kill that cancer.”
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