NEW ORLEANS -- It was in 1966 when the science fiction movie "Fantastic Voyage" miniaturized doctors to go inside a patient's body. And while science is not there yet, doctors at a local hospital have new technology that allows them to see inside the body at 1,000 times magnification, just like in the movie.
It's a big day for 60-year-old Belinda McGee. New technology is about to give doctors a chance to see inside her body like never before. They want to know what is causing her problems.
"When I would eat my food it seems like my food would block. I figured it was my gallbladder, you know, you talk amongst each other and you get the symptoms," said McGee.
She had her gallbladder removed at a hospital near her home in Basile, Louisiana, west of Lafayette. But still she was losing weight. Something was wrong.
"The pain got so bad one night I went through the emergency room and the next morning they transferred my to Our Lady of Lourdes in Lafayette," she said.
McGee knows what the doctors fear: cancer in the liver's bile duct.
"I'm just going to take it as it comes. That's the only thing I can do," said McGee when asked about how she feels emotionally about the upcoming procedure.
Doctors, and a team of nurses and technicians at Tulane Medical Center, are preparing McGee to have a procedure using the world's smallest, flexible microscope. It can go in an endoscope down her throat or in a colonoscopy up through the colon.
"At one cell you can find colon cancer. We can find very small area of abnormality that the eye may not pick up even with the regular technology which we have," said gastroenterologist Dr. Virendra Joshi, a Tulane Medical School associate professor of medicine who is also the director of Advanced Endoscopy Fellowship.
While McGee is under anesthesia, Joshi uses the instrument to go all the way down through the mouth, esophagus, stomach and into the small intestines. He finds the opening to the bile duct, the small tube that dumps digestive fluids into the intestines. He can see where the instrument is in the body using X-ray, so all of us in the O.R. are protected by lead clothing shields.
There is a camera on the end so the team can see clearly inside of the patient. There is also a SpyGlass camera that goes into the small bile duct, which is only a quarter of an inch wide. Here you can see past the normal, smooth white tissue to a red, blocked area that appears to be bleeding.
This is the area of obstruction that is of concern. Joshi uses pinchers to grab a piece of the suspicious area for biopsy. But when the tiny microscope called the Cellvizio is put into that duct, you can see the area at 1,000 times magnification. You can actually see the blood cells flowing in the vessels. If the obstruction looks benign, the doctor can open it up on the spot and McGee would be done.
But when Dr. Joshi sees dark areas, with larger blood vessels, he is suspicious that it is in fact cancer, and McGee will need to go to a surgeon.
"Our focus is cancer and colon cancer, stomach cancer, esophageal cancer. These are prevention, so if you see something abnormal early, OK, you can pick it up. You can give treatment right away. So early detection, it helps in early detection," Joshi said.
The patient can now be in the hands of a surgeon the next day, which is good, since this can be a fast growing cancer. In the past, the biopsy may have taken a week in the lab.
Patients with many colon polyps can also benefit because with the tiny microscope. Doctors can tell on the spot which ones to remove immediately and which ones are benign and can be left alone, saving patients time, extra procedures and from undergoing the scalpel.
"I think we can use this new imaging technology to basically improve patient care," Joshi said.
The Cellvizio focal probe is FDA approved and Tulane is one of about 30 centers in the U.S. using it.
Bile duct cancers are more common in Southeast Louisiana because of high fat diets, alcohol and smoking.
