The history of digestive endoscopy

Abstract

In the early 19th century, elementary attempts were made to observe the larynx, rectum, vagina, and urinary tract using primitive endoscopes. In 1868, Kussmaul attempted to observe the inside of the stomach with a rigid straight tube, achieving no successful results. Around this time, it was discovered that bright light is gained by sending electricity to a platinum wire under cooling with running water. After that, many different types of rigid gastroscopes were, developed with this newly discovered system as the light source, which was an incandescent platinum wire at first, then miniature light bulbs. In 1932, Schindler developed a flexible gastroscope with a bending function at the tip. Several experiments were also conducted to make a diagnosis by photographs taken with a miniature camera inserted in the stomach. Lange et al. and other researchers engaged in this approach, but none of their apparatuses could stand practical clinical use. In 1950, completely separately from Lange's experiment, Uji et al. developed the gastrocamera. Although Uji's gastrocamera could not withstand practical use either, Tasaka's group at the First Department of Internal Medicine, Faculty of Medicine, University of Tokyo, had started clinical experiments with the gastrocamera in 1953 and added various improvements to make it a truly practical medical device. In 1957, Hirschowitz made a fiberscope. Based on this technology, the gastrocamera equipped with a fiberscope was developed and disseminated widely throughout Japan. As the technology of fiberscopes advanced, endos copes for colon, esophagus, and duodenum were developed as well. The videoscope, which has become the mainstream of endoscopes today, was developed as television technology progressed. Image enhancement, image analysis, and narrow-band imaging technology are the hot topics in endoscopy today. Autofluorescence imaging is also one of the recent topics of endoscopy. In this chapter, the author foresees the future advancement of endoscopy. © 2008 Springer Japan.