Gastroscope

I. From the beginning of the last Century many of the medical advancements were due in part to the development of the gastroscope, which produced modern endoscopy.
A.The inability to examine the human body internally prevented early diagnoses and treatment.

B.Without an instrument to see inside the body, physicians were limited to primitive surgeries.

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a.An exploratory surgery could be more life threatening than the ailment.
b.(Autopsy) In order to examine the body the victim had to be dead.

C.The importance of endoscopy is to examine the body, with precision, accuracy, and with minimal bodily harm.
II. German physician, Kussmaul Bonzzini developed the first gastroscope in 1805 (Lichleiter).
A.This creation was limited to looking inside the stomach cavity.

B.It was made of a straight, rigid, metal tube, and was illuminated by a candle.

C.The general application of the rigid gastroscope was restricted to the stomach (colon) and esophagus due…
D. These Gastroscopes were first tested on sword-swallowers.
a.(Legend) One sword-swallower upon seeing the bulky instrument proclaimed “, I’ll swallow a sword anytime, but I’ll be damned if I swallow a trumpet.”
E.William Hill, a London Physician added a miniature light bulb to Bonzzini gastroscope in 1912. (This followed Edison’s invention of the light bulb. Edison invented the first incandescent bulb October 21,1879 a high-voltage carbon-filament lamp)
III. In the late 1930s, Schiendler invented the a semiflexible gastroscope.
A.The semiflexible gastroscope consisted of a steel tube with a flexible tip that permitted it to flex 30 degrees to assist intubation to permit visual images of tangential lesions. (Intubation- the process of putting an endoscope in a body)
B.The disadvantages of the semiflexible gastroscope were…
a.patient discomfort from neck hypertension during intubation from the mostly rigid instrument.
b.It was a moderately high-risk procedure…
c. and the inability to visualize the stomach and the entire esophagus or duodenum.

C.In 1947, Uji and the Olympus Corporations of Japan invented a miniature intragastric camera and flash lighting to photograph various parts of the stomach according to preset camera positions.
a.The gastrocamera was intubated blindly into the stomach and photographed without visual guidance.
b.The stomach was only visualized after film development after the examination.
VI. A succession of physicists began the process of developing a flberoptic gastroscope.

A.Beginning with British Physicist, Tyndall who demonstrated that light would follow a curved path in water in 1870.

B.Next, in 1927, Baird proposed that light could be transmitted through glass fibers.

C. Then Lamm, a third year medical student at Munich Germany, reported the successful transmission of visual image via fiberoptic bundles, in 1930.

D.In 1954, Hopkins and Kaperny constructed a meticulous bundle of insulated glass fibers that transmitted light or visual images through a nonlinear path.
a.Their laboratory models were only a few inches long…
b.and did not transmit light sufficiently for gastroscopic use.

E.In 1957, Basil Hirschowitz found that many optical fibers needed to be arranged exactly in the same relative position at both ends of a fiber optic tube to transmit a high-resolution image without distortion.

a.Hirschowitz, Curtiss and coworkers embedded thin optical glass fibers in a matrix, with low refractive index;
i.the glass matrix served as an insulating coat for individual optical fiber to permit nearly total internal reflection of light waves around turns.

b.With the help of American Cystosope Makers Inc. (ACMI) Hirschowitz added manual steering controls to devise a fully flexible fiber optic gastroscope.
i.The production of the prototype gastroscope was made within 6 weeks.

1.Hunter Hirschowitz tested the instrument in humans on himself.

ii.AMCI Introduced the first commercial model, the AMCI#4990, in 1960.

c.Hirschowitz replaced the side-viewing objective with a safer and simpler end-viewing objective, in the early 60’s.

i.Hirschowitz added a channel for endoscopic biopsies, and an external light source to provide cold light transmitted by fiberoptic bundles, in 1963.

d.The endoscopy was no longer limited to the stomach (colon) and lungs.

i.Specialized tools were attached like…
1.Scalpels, syringe, drills or saws, forceps, and hypodermic needles …
ii.…so delicate operations inside of a body could be performed throughout the body.

V. Fiberoptics cables in endoscopy were replaced by Charged Coupled Devices (CCD), in the 1980’s and are commonly used to this day.

A. The CCD’s are tiny cameras that that transmit images to a television via electrical wires.
C.CCD’s often have countless specialized tools.

VI. (Conclusion) Overall the endoscope has had a dynamic effect on modern medicine.

A.Since 1910, many mysteries of the human body were solved using endoscopic technology.

a.Early diagnoses are now safe and more reliable.
b.Millions have been able to live longer.
c.The quality of life has been enhanced.

B.Medical advancements on the Gastroscope evolved modern endoscopy.
a.Such advancements followed innovation in technology;
i.the invention of the microscope, light bulb, camera, television, fiberoptics, and micro technologies.
C. The rapid changes in technology are changing medicine.


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