Present and future developments in endoscopy

Abstract

The invention of the rod-lens system and its clinical applications created a new chapter in endoscopy performed with rigid scopes. A few examples in miniaturization and the diagnostic value of its implications are discussed.The impact of this new system is shown with data indicating the significant increase of examinations. The introduction of flexible fibre endoscopes opened new and more accurate diagnostic modalities in the gastro-intestinal tract. Results of certain procedures are analysed and the still existing problems mentioned. The extensive use of high-frequency electrosurgery during procedures drew attention to certain risk factors concluding in thermal injuries; the need for safer and better electrosurgical units are emphasized and preliminary data of laser applications mentioned. Illumination sources are in a chaotic state. The need for one universal examining stroboscopic and continuous high-intensity light source, which is built within safe parameters (u. v. and i. r.) are stressed. Some data from an experimental model of a more efficient and safe light source are discussed. The incoherent fibre light transmission is in general employed in every rigid and flexible endoscope. The light absorption is significant (33 - 50 % per metre). A new flexible light transmitting medium, with much better transmitting characteristics, is now available. The need for a second observer (assistant) is obvious. The various teaching attachments, including a new one, are compared. An objective permanent film record from any visual examination is of paramount importance. The problems of high absorption of the image transmitting systems for cine or still photography create difficulties. The advent of new illumination sources and improved light-transmitting media opened the field to the development of miniaturized 16 mm and 35 mm cameras. The various aspects of automatic brightness and exposure control are discussed as well as the possibilities of employing black and white and colour television.