The role of the surgeon in the evolution of flexible endoscopy

Abstract

Several cultures, including the Egyptians, Greeks, Romans, and Arabs, made attempts to view accessible human body cavities using a variety of instruments such as spatulas and specula. The first endoscope was created in 1806 when Phillip Bozzini, a German-born urologist, constructed the lichtleiter, which used concave mirrors to reflect candlelight through an open tube into the esophagus, bladder, or rectum. Maximilian Carl-Friedrich Nitze, another German urologist, produced the first usable cystoscope in 1877 by using series of lenses to increase magnification. He was also the first to place light inside the organ of interest to aid visualization. In 1880 Mikulicz made the first gastroscope using a system similar to Nitze's cystoscope. Modern endoscopy was born with the introduction of the fiberoptic endoscope in the late 1950s. Over the ensuing 50 years endoscopy revolutionized many aspects of the surgeon's practice. Endoscopy can now be used to diagnose and often treat gastrointestinal cancer, hemorrhage, obstruction, and inflammatory conditions. This review was initiated by the SAGES Flexible Endoscopy Committee to chronicle the role of the surgeon in the development and introduction of flexible endoscopy into clinical practice, historically and in contemporary surgery. Flexible endoscopy evolved out of surgeons' need to overcome diagnostic and therapeutic challenges. There have been many recent technological advances that facilitate endoluminal therapies, and flexible endoscopy is now traversing new ground. Surgeons have been major contributors in the development of all aspects of endoscopy. There is a continually expanding list of therapeutic options available to patients. The difficult questions of which procedure, on which patient, and when can be answered best by the surgeon versed in endoscopic, laparoscopic, and open surgical techniques.

The Impact of Endoscopy Training During Residency on the Diagnostic

“…Following the usage of the first fiber optic endoscopy in 1957 for GIS investigation, the endsocopist surgeon William S. Mc Cune made ERCP in 1968. Yaumans and colleagues who were surgeon stopped in 1969 the gastric bleeding by means of endoscopic intervention and in 1979 the surgeons placed the first PEG [6][7][8][9]. In our country the surgeons showed increased interest to endoscopy in the last 40 years [1].…”

The role of surgeons on the development and performance of endoscopy

“…Philipp Bozzini, the father of endoscopy, Adolf Kussmaul who used sunlight as an artificial light source and known by some authors as the father of gastroenterology, Max Nitze who developed and used cystoscopy, Johann von Mikulicz-Radecki who used rigid gastroscopy for the first time, Dimitrij Oscarovic Ott who performed the first peritoneoscopy with tube endoscopy at the same time with Georg Kelling are all surgeons who demonstratedtheir skills inthe endoscopic area as well (8,15). Kussmaul was the first to use gastric tubes for therapeutic purposes.…”

“…Nitze developed the first cystoscopy in 1877 (6). Another general surgeon, Johann von Mikulicz-Radecki, was the first to perform rigid gastroscopy under morphine sedation (7,8). The semi-flexible tube endoscope was first developed and used by Georg Kelling in 1898 (9).…”

“…Schindler, along with Wolf, has made semi-flexible endoscopy widely available and is considered the father of gastroscopy. Basil Hirschowitz developed and used the first fiberoptic endoscopy in 1957 (3,8). In summary, the physicians mentioned above have been the pioneers in the development of today's endoscopy systems.…”

Flexible Cystoscope for Evaluating Pelvic Fracture Urethral Distraction Defects

“…It is clear, however, that flexible endoscopy will continue to evolve. Surgeons have been major contributors in the development of all aspects of endoscopy and we are well positioned to evaluate these technologies for efficacy [21]. …”