A magnet makes "travel" through stomach and intestines possible via capsule endoscopy

It is really a very "fine" thing: Instead of a relatively thick endoscope, patients now only need to swallow a very small capsule containing two tiny cameras that provide clear images of the interior of the stomach and intestines. Capsule endoscopy is not new. However, technical advances now even make it possible to move the capsule where it is supposed to go - controlled and manipulated by magnetic force. A particularly sophisticated model is a capsule that moves on its own "two feet". Today's state-of-the-art diagnostics in digestive tract imaging and what could be routine in the future is once again the topic at MEDICA 211, the world's largest medical trade fair to be held in Düsseldorf, Germany (November 16 -19, 2011) with over 4,500 exhibitors from 60 countries.

Capsule endoscopy can be used in all diseases of the small intestine in which conventional methods are unable or insufficient to shed any light. Private lecturer Dr. Jutta Keller of the medical clinic at the Israeli Hospital in Hamburg says that evidence of the sources of bleeding in the small intestine remains the most important indication for the method. Based on a resolution of the Joint Federal Commission of 2010, with this indication capsule endoscopy is now paid for by the German health care system. The method is recommended and applied, amongst others, in cases of suspected Crohn's disease in the small intestine, complicated sprue and when other tumours of the small intestine are suspected. In addition, says Dr. Keller, there are systems for examining the oesophagus and colon, the limits of whose clinical uses are not yet clear. Capsule diagnostics is not indicated for passage disorders of the gastrointestinal tract. Nor should it be used on patients with pacemakers, those with a history of multiple abdominal operations, and pregnant women. Obviously the method cannot yet completely replace conventional endoscopy of the stomach and colon. One reason: Biopsies are not possible. According to the gastroenterologist, one of the greatest disadvantages of capsule endoscopy to date has been the lack of controllability of the capsules. For that reason, new and different systems have been developed or are currently in the development phase.
Guiding hand-held magnets: relatively simple but nevertheless effective

The most advanced systems are controlled by means of magnetic forces. This requires a capsule made of magnetic material and an exterior magnetic field. One option, for example, is control by means of a hand-held magnet. Such a system was developed in a European research project (NEMO: nano based capsule-endoscopy with molecular imaging and optical biopsy). According to Dr. Keller, the system is based on a hand-held magnet developed by the Fraunhofer Institute in St. Ingbert and a modified capsule endoscope developed by the Israeli company Given Imaging Ltd., a leading producer of capsule endoscopes. Initial clinical trials with the hand-held magnet system were quite successful, says Keller. A targeted and comprehensive examination of specific structures was successful in most subjects, most of the mucosal lining of the stomach could be displayed.

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