Flexible Microscope Explores Deeply Hidden Cells

A tiny, flexible microscope allows surgeons to view living tissue in real time at the cellular level during regular endoscopy procedures, precisely pinpointing what should be immediately removed or treated.

The device, dubbed a probe-based confocal laser endomicroscope and marketed by Paris-based Mauna Kea Technologies as Cellvizio, is designed to diagnose gastrointestinal and biliary diseases.

A microimaging system located at the end of a catheter that is threaded through a traditional endoscope is making it easier for gastrointestinal surgeons to locate diseased tissues without a biopsy. (Photo: Mauna Kea Technologies)

Typically, if a surgeon finds areas that appear abnormal during an endoscopic procedure, the suspect tissue is sent to a laboratory for analysis, which could take as long as a week for results, according to Dr. Bob Etemad, a gastroenterologist at Lankenau Medical Center near Philadelphia, one of 50 US centers now using the Cellvizio system.

“This sometimes is a problem when the biopsies do not confirm our suspicions,” he said. “We may then need to rebiopsy with an additional procedure. The eye is also not as sensitive to detect some subtle but dangerous precancerous changes. With Cellvizio, we have a tool that helps us better identify the dangerous tissue during the initial diagnostic exam, removing it the same day and then going back to ensure we removed it all. We have a lot more information.”

Cellvizio allows doctors to more accurately differentiate cancerous and precancerous changes in tissue during colonoscopies, endoscopies and the standard pancreatic and bile duct cancer detection procedure.

The microscope is located at the end of a catheter that is threaded through a traditional endoscope while a patient is having an endoscopy or a colonoscopy. Cells that are precancerous or cancerous appear as black spots, thanks to the administration of intravenous fluorescein. It adds only a few minutes to the standard endoscopic exam and poses no additional risks.

Etemad recently treated Deanne Sherman, who was diagnosed with Barrett’s esophagus, a condition of abnormal precancerous change in the lower esophagus. Sherman was told by her physician that she would need her esophagus removed, but learned from Etemad that invasive surgery was unnecessary.

“After three minimally invasive endoscopy procedures, I am cancer-free and ready to live my life,” she said.

For more information, visit: www.maunakeatech.com or www.mainlinehealth.org/Lankenau