As it turns out, the concept of capsule endoscopy has been relatively easy for physicians and patients alike to digest. In fact, the innovative pill camera technology, pioneered by Given Imaging in 2001, has proven to be a less-invasive and effective means of visualizing and diagnosing conditions or problems in the small intestine. But while the underlying diagnostic technology offers indisputable advantages, the gut feeling of healthcare providers is that these patient-friendly devices should offer some semblance of control or maneuverability to optimize patient care.

Endeavoring to address this market need, researchers at Brigham and Women's Hospital (BWH) recently announced that they have developed an endoscopic capsule that provides clinicians with the ability to control the movement of the pill inside the body using an MRI machine. Like the pill cameras currently on the market, the researchers' version is ingested and captures a multitude of images as it travels through the digestive tract. Images are transmitted wirelessly and examined by trained gastroenterologists.

In contrast to existing capsules, however, the BWH team's pill camera can exercise control over the contents being photographed, and can steer the pill toward areas of interest or concern for better diagnoses. Current pill cameras simply move through the body at random. "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," says Noby Hata, a researcher in the hospital's department of radiology and leader of the development team for the endoscopic capsule. "Ideally, in the future, we would be able to utilize this technology to deliver drugs or other treatments, such as laser surgery, directly to tumors or injuries within the digestive tract."

Like BWH, a team of German researchers made strides in the area of capsule endoscopy last year when it demonstrated the feasibility of guiding a modified capsule endoscope through the stomach of healthy patients using magnetic materials. Conventional capsule endoscopies are suited for diagnosis of conditions or problems in the small intestine, yielding variable image results for areas such as the stomach. However, studies have indicated that gastric cancer screening could reduce mortality rates, and capsule endoscopies could offer a patient-friendly alternative to upper endoscopy procedures.

"To address the problems with a conventional capsule endoscope in visualizing the stomach, a new tool for maneuvering the capsule using an external handheld magnet was developed, allowing targeted investigation of all regions of the stomach," says study lead author Junta Keller of the department of internal medicine at the University of Hamburg. "The aim of our study was to evaluate the safety and feasibility of the magnetic maneuvering of a capsule endoscope in a human stomach. We found that the magnetic maneuvering of the capsule was safe and very well-tolerated, with excellent responsiveness of the capsule to movements of the outer magnet so that detailed visualization of the gastric mucosa could be achieved." The researchers employed a handheld external magnet for the experiment.

Such controllable spins on the conventional pill camera demonstrate promising innovation and a distinct trend in next-generation capsule endoscopy device designs. As a result, these controllable device designs will likely facilitate earlier and more-accurate diagnoses of digestive tract complications or conditions. And these promises represent a concept that is pretty easy to swallow. --Shana Leonard