THE HISTORY OF ENDOSCOPY, ESPECIALLY OF GASTROSCOPY (PART 3)-THE DEVELOPMENT OF FLEXIBLE ENDOSCOPES-

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• For the perfect observation of the intricated gastric lining, a flexible endoscope was inevitable. The very difficult question how to convey an image along a curved axis had been solved by G. Wolf, a cystoscope-maker in Berlin and R. Schindler in Munich for the first time. Rudolf Schindler is a man who devoted all his life for the completion of a safe gastroscope, for the establishment of the techniques for painless examination and the endoscopic diagnostics of every gastric pathology. He well claims the name 'the father of gastroscopy.' Their flexible gastroscope was completed in 1932. It was 78 cm long and over 44 lenses were incorporated inside. Its distal half could be curved gently until 34°. The observation of the pyloric ring was possible in over 80% of the cases. Their flexible gastroscope was introduced to every country in a short period of time. H. Nakatani, a surgeon of Tokyo University, brought it back to Japan in 1933 after he had took the Schindler's short course on it. In 1934 S. Kirihara, a surgeon of Nagoya University, and M. Takei, a cystoscope-maker in Tokyo, succeeded to make its copy and in 1937 they improved its flexible portion to be controllable. In 1943 the first Japanese textbook on gastroscopy was written by Kirihara. However a flexible gastroscope was used only by few hands of selected university hospitals. In 1889, M. Einhorn in New York introduced an electric bulb into the stomach and estimated the size of the stomach and its position by the light on the abdominal wall. He named it as 'gastrodiaphany.' In 1898, F. Lange and D. Meltzing in Munich made a miniature camera installed in the tip of a flexible gummy tube. Over 50 gastric photographs 4 mm in diameter were taken on a strip of film. However they failed to get satisfactory pictures. In 1930, F. G. Back, J. Heilperin and 0. Porges in Wien made an instrument named as 'gastrophotor'. Eight pair of black and white stereo-photographs were taken by one shot of flash. This was used in Europe and United States for some time but soon discarded in the presence of the Schindler's gastroscope. In 1950 T. Uzi, a surgeon of Tokyo University Branch Hospital, M. Sugiura and M. Fukami, engineers of Olympus Optical Co., invented a camera to be inserted into the gastric cavity and called it as 'gastrocamera.' Twenty five to thirty pictures can be taken on a strip cf 30 cm long film. Photographing of the various parts of the stomch was conducted by referring to the flash transilluminated through the abdominal wall. The utilization of newly developed materials after the 2nd world war, especially that of colorfilm in 1953, made it of practical use. S. Tasaka, a professor of Tokyo University and his disciples T. Sakita, S. Ashizawa et al played an active part for the improvement of the gastrocamera, how to use it and the propagation of their technique. After the completion of the 5th model of the gastrocamera (GT-V ), it was used by many doctors even for mass-survey against stomach cancer in Japan. The easy interpretation of its sharp color photographs was one of the reasons for its big success. The Gastrocamera Study Club established in 1955 by S. Tasaka and T. Hayashida, a professor of Tokyo University Branch Hospital, developed to Japanese Society of Gastrocamera, in 1971 to Japanese Society of Gastroenterological Endoscopy. In 1964 a fiberscope was incorporated to the gastrocamera (GTF) and photographing under visual control became possible. In 1966 the first International Congress of Gastrointestinal Endoscopy was held in Tokyo. The transmission of light along a curved glass-rod was known since Grecian age. The first experiment of image transmission with a bundle of flexible quartz fiber was undertaken by H. Lamm, a medical student of Munich University in 1930. He tried its application for a gastroscope but it was not materialized. In 1954 N. S. Kapany, a physicist in London and van Heel, a physicist in Holland reported on an opticalfiber-bundle

• 社団法人 日本消化器内視鏡学会の論文

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