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The bane of adults over 50 - the colonoscopy procedure to detect precancerous lesions in the large intestine (colon) - will become obsolete within the coming decade thanks to any of five innovative endoscopic technologies, four of which have been developed by Israelis.
This was the prediction on Thursday of Prof. Shimon Bar-Meir, chief of the gastroenterology institute at Sheba Medical Center at Tel Hashomer and a faculty member at Tel Aviv University's Sackler Medical School. He was speaking at the 18th Israel Medical Association World Fellowship International Conference at Jerusalem's Inbal Hotel.
The conference, which will be held through Sunday with participation by some 150 Jewish physicians from abroad and 50 from Israel, is focused on "Advanced Technologies in Medicine."
Within 10 years, colonoscopy - in which a tube encasing a tiny camera is pushed into the rectum and colon under sedation after the patient drinks a large amount of unpleasant liquids to make the interior visible - will not be used anymore or even be available, Bar-Meir said.
"That is because we will have an endoscopic alternative" to the method for detecting this type of cancer, which is a leading cause of death, he said.
Many people over 50 (and those over 40 who have first-degree relatives who had colon cancer) do not go for a periodic colonoscopy because "it is embarrassing, painful, requires a sedative and is invasive," Bar-Meir said.
Of the five technologies, he said, four are Israeli-developed and three of them are the most promising: Aer-O-Scope, a new version of the Given Imaging PillCam (both developed by Israeli companies) and NeoGuide (the last developed by an Israeli living in California's Silicon Valley).
The Aer-O-Scope will cost approximately $250 for the equipment, including two inflatable balloons, each on the other end of the colon. Connected to a camera, the balloons take high-resolution images of the entire colon, 360 degrees around, making it very unlikely that pre-cancerous lesions will be missed.
"This self-propelled optical device operates at the push of a button and is not dependent on the skill of the operator," Bar-Meir said. "The equipment is disposable and the procedure sedation-free."
It has been successfully tested on pigs, which have very convoluted colons, he added. It has also been used on 12 people, including two who were unable to have colonoscopies for technical reasons.
The only drawback of Aer-O-Scope, said Bar-Meir, is that it can be used only for diagnostic purposes - to find pre-cancerous polyps - but not to remove them, which is done in a colonoscopy.
The NeoGuide - whose disposable, steerable tip leads the way for 15 segments that follow it - will only cost around $21 and can be used for both diagnostics and treatment, Bar-Meir said. Each segment is computer-controlled, and together it produces a 3-D map of the endoscope's path through the colon, without any polyps being pressed against the wall. It can also mark sites of polyps for later identification and was successful in tests on 10 patients, including two with severe diverticulosis.
The new version of the Given Imaging swallowable PillCam will cost around $500 and is ingested. Unlike the small-intestine PillCam, which is widely in use, it takes images for three minutes, then "goes to sleep" while it travels through the small intestine (to save energy) and then "wakes up" when it reaches the colon 100 minutes later. Five clinical studies comparing images from conventional colonoscopies and the PillCam showed the latter is very effective, Bar-Meir said.
Vice Premier Shimon Peres, who addressed conference participants, said Israel's 1.4 million Arabs received very good health care here, and that in some hospitals, such as Emek Medical Center in Afula, Arab doctors and nurses constitute 30 percent of the medical staff.
Peres proposed that a fifth public medical school be opened in the Galilee to teach on the highest level and increase the number of Israeli medical graduates.
Peres also said the Peres Center for Peace had paid for the treatment of 2,000 Palestinian children who were wounded in clashes with Israeli forces, and an additional 1,000 children who suffered from medical problems. The cost was $10,000 per child for hospitalization and accommodations for them and their families in Israel, he said.
When his center was unable to raise the $70,000 per child for treating young cancer patients from the Palestinian Authority, Peres said, it trained Palestinian doctors and gave them equipment for treating the youngsters near their homes. Peres said his center had avoided publicizing these achievements out of fear that it would be regarded as a publicity stunt.