Abstract
The development of gastrointestinal endoscopes is now dictated by medical requirements. The physician is in the happy situation of being 'served ’ by physicists, engineers and instrument makers who are able to satisfy his clinical desires. Milestones along this path are the replacement of the rigid endoscope by Schindler in 1932, the development of fully flexible fibre optic instruments in about 1958, and the improvement of the optical quality with simultaneous reduction in the diameter of the instrument using the Hopkins Optical System since 1965. At the present state-of-the-art, there are six main properties of the endoscope which have been improved step by step. 1. Extension viewing : achieved by the use of optically excellent bundles of glass fibres, flexibility of the tip of the instrument, which can be moved in each of 2 planes through almost 360°, and the panning lens system which makes it possible to use the same instrument either in the forward-viewing or the side-viewing mode. 2. Combination of methods : combination of inspection and documentation. Combination of inspection and extended biopsy facility: big particle biopsy. Combination of diagnostic and therapeutic endoscopy: polypectomy, arrest of bleeding, papillotomy, extraction of gallstones. 3. Ease of handlig : rounded tips, reduced diameter, well-contrived arrangement of operating controls for the mechanical and optical systems. 4. Economy : production of robust instruments at a reasonable price. 5. Research : measurement of pH at selected sites in the stomach; potential difference measurement at the gastric and duodenal mucosa; manometry in the region of the sphincter of Oddi; accurate placement of tubes; extraction of pure secretion from the liver and the pancreas. 6. New trends : introduction of laser light into the gastrointestinal tract for the purpose of arresting bleeding with graded application of power, introduction of ultrasonic energy for lithotripsy.
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