At the royal college of Physicians
and surgeons of Glasgow
and surgeons of Glasgow
Medical examinations often require the examination of the inside of the body to diagnose patient conditions. This "scopy" has been a mode of diagnosis for many years, a way in which practitioners can see inside the human body without having to make any invasive incisions. However, endoscopic techniques haven't always been easy or comfortable for patients.
Endoscopy is a technique used by practitioners to look inside the human body and examine the interior for diagnosis. This technique requires the insertion of an endoscope, an optical instrument, into the body through an opening such as the mouth. Endoscopes can come in the form of long flexible tubes that can be passed along the oesophogus or tiny capsules that can be swallowed completely.
Unsurprisingly, the inside of the human body can appear dark if there is not proper illumination during an endoscopic examination. Either the endoscope itself needs to have a light source attached or an external light source is provided through another instrument. The “5 in 1 Electro-diagnostoset” includes a number of lamps designed to fit various instruments. These lamps can be connected to a power supply and screwed into the handle of an instrument, providing illumination for examination, diagnosis and surgery. For example, the oralite acts as a tongue depressor, with a light attachment to illuminate the back of the mouth and entrance to the throat, whereas the surgilite was used to illuminate difficult to reach parts of the mouth when removing teeth. Many of the instruments in this diagnostic set use transillumination, the shining of light through body tissues, to highlight different parts of the body during endoscopic procedures.
Gastroscopy is the examination of the upper part of the digestive system, from the throat down to the stomach. Rudolf Schindler was the brains behind the first ever semi-flexible gastroscope, created in 1931 along with Berlin manufacturer, Georg Wolf. He constructed the gastroscope in such a manner that the distal end could be rotated, while the proximal end remained stationary. This allowed easier access to all areas of the stomach.
Before patenting the device, Schindler had to test it out on a variety of patients. Often, his instruments were tested on his own children, especially his daughter Ursula as she had a strong gag reflex. The examination with Schindler's gastroscope had to be carried out in a very specific manner. Due to the limitations on flexibility, the patient had to be positioned in order that the gastroscope could simply slide down the oesophagus towards the stomach. It would then be rotated to visualize all areas of the stomach. This wasn't the easiest of procedures; for gastroscopy to advance, something had to be done to the gastroscope itself.
Schindler's mode of gastroscopy was the world standard before the development of fibreoptic endoscopy. Gastroscopy today involves examining components of the gastrointestinal system by inserting a thin, flexible tube down the patient’s throat. This endoscope contains a camera and light, and is controlled by the physician performing the examination. The images from the camera are then fed to a monitor screen for visualisation. Although it is still not an entirely comfortable procedure for the patient, the flexibility of gastroscopes today is a vast improvement from the times of Schindler's examinations.