Measuring nine metres in length and with close contact to numerous vital organs, the digestive tract is fundamental to the health of the entire human body. Medical experts agree that early detection of intestinal diseases such as tumours, Crohn's disease and a syndrome called "obscure gastrointestinal bleeding" can significantly increase the chances of patient survival - up to 96% in the case of certain gastrointestinal cancers. For centuries, however, the body's small intestine remained beyond the reach of conventional diagnostic procedures and could only be explored through surgery.
Israeli inventor Gavriel Iddan transformed the field of gastroenterology with his invention of an ingestible pill-sized camera, the first form of non-surgical diagnosis of the small intestine. For his work in medical diagnostics, he has been nominated in the Non-European countries category for the 2011 European Inventor of the Year Award. The award will be presented on 19 May at a ceremony in Budapest.
The Israeli inventor is being considered for his invention of the PillCam, a tool offering medical professionals access to uncharted territory in the small intestine. His form of wireless capsule endoscopy offers an alternative to more invasive or less patient-friendly procedures for the detection of gastrointestinal diseases.
The field of endoscopy - from the Greek "looking inside" - has grown in leaps and bounds since Italian inventor Philip Bozzini first created a rigid tube-like apparatus called a "Lichtleiter" (light guiding instrument) in 1805. Groundbreaking follow-ups included the flexible endoscope from Kelling in 1898, Soulas' video endoscopy in 1956 and fibre optic endoscopy by Hirschowitz in 1957.
But despite these advancements in terms of image quality, endoscopes continued to face serious limitations: They were only able to diagnose either the upper 1.2 metres of the intestinal tract by inserting a gastroscope through the patient's mouth, or the last 1.8 metres of the large intestine by means of colonoscopy. In between, around six metres of unmapped territory remained beyond the grasp of endoscopic devices - an area called the small intestine, so-named because the size of its diameter precludes the advance of endoscopic tools. In this area, even X-Rays and ultrasounds failed to yield useful images, leaving potentially risky exploratory surgery as the only method for gastrointestinal diagnostics.
Then in 1981, a friend of rocket engineer Gavriel Iddan began experiencing serious, inexplicable pain in the area of his small intestine. Having worked on optical guiding systems that relayed missile-like devices towards their targets, Iddan asked a seemingly preposterous question: What if you could steer a camera-equipped "missile" through the gastrointestinal tract to record pictures of the small intestine?
At the time, Iddan's idea seemed closer to the realm of science fiction than to actual science. But over the course of almost twenty years, technology caught up with Iddan's vision. Key factors included improvements in micro-cameras, LEDs (for lighting up the intestine) and ever-smaller transmitters for sending the image data to the outside.
By 1998, Iddan was able to fit the camera, LEDs, batteries and a transmitter inside a small capsule the size of a vitamin pill. Coated with acid-resistant plastic, it could withstand the voyage through the digestive tract, moving ahead naturally through the peristaltic activity of the intestinal muscles. The big advantage: Throughout the 8.5-hour diagnostic procedure, patients can carry on with their usual daily activities, foregoing pre-preparation or sedation.
To market the technology, Gavriel Iddan co-founded Given Imaging in Israel and premiered the invention as a prototype at the 11th World Congress on Gastroenterology in Vienna in 1998. Since then, "wireless capsule endoscopy" has become established as the global standard for small bowel diagnostics.
The technology, marketed as "PillCam" from 2001 onwards, also brought substantial financial success to Given Imaging. Government approval for diagnostic use in the US occurred in 2001 with Given Imaging reporting net sales of $4.73 million that same year.
In 2010, Given Imaging sold 221,300 PillCam capsules and reported revenues of $157.8 million. Since its official release in 2001, the PillCam has been used almost 1.5 million times by more then 5 000 medical facilities in over 75 countries.