History And Evolution Of Endoscopy

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History and evolution of endoscopy

The term endosopy comes from the Greek word Endo: interior and scopia: observe;It is a diagnostic technique part of medicine that allows visualizing the interior of a hollow organ or body cavity through the instrument called endoscope, as established by the Royal Academy of Language. 

Formerly, several instruments for the observation of the human body were used from the exterior to the interior, in which it was implemented of tubular materials with the purpose of obtaining a diagnosis purpose of the diseases present in the mouth, nostrils, external auditory canal, external auditory canal,oropharynx, straight, etc.

The medical literature affirms that, Hippocrates being the father of medicine would have used a tube with a candle as light sources for the examination of the rectum, while Greeks, Egyptians and Romans used cannulas for enemas.

In the year 936 Albuskasim was the first to use the light reflection to observe internal cavities such as that of its anatomically oral strings.

Hilden Fabry invented the Speculum Auris in 1580, which is still used, but it was not until the early nineteenth century, when endoscopy evolved.

The first demonstrated prototype was built by the Phillip Bozzini doctor, which I call a light driver, formed by a thin tube and illuminated by a flame whose light was reflected through a mirror, which I use to examine urethra,Urinary bladder and vagina, however, was not accepted by doctors of that time;However, the development of endoscopes remained solidified for almost 50 years. Continuing with Bozzini’s work, Antoninin J Deoreaux improved the device by replacing the candle with a kind of fuse lamp that burned a mixture of ethyl alcohol and treason, unfortunately, the instrument was not successful for the burns that it produced in patients duringyour exploration;However, this technique was reconsidered and accepted by the doctors of that time.(two)

In 1869, Gustave Touve built the first endoscope equipped with electric lighting, which contained platinum fibers through which it was possiblewet;For which an endoscopic model was designed by Maximilian Nitze but with a continuous cooling system with ice water and telescopic optics, this technique was considered the first modern cystoscope in 1877.

Adolf Kussmaul, in 1868 he was the first to experience esophagogastososcopy, whose technical basis consisted of introducing the rigid instrument, based on swallowable practices;However, in 1881 Johannvon Mikulicz and Josef Leiter created the sphagoscope in which it was possible to observe functional aspects of the esophagus, these advances allowed the endoscope to be considered as an optical system, with a tubular body and a source of electric light.

In 1911, Michael Hoffman demonstrated an image in which it could be transmitted through an endoscope with curved handling linked to the short -approach prisms, called semi -flexible endoscopes but was improved shortly after other authors such as Dr Rudolph Schindler and George Wolfry in1942 in which it was allowed to take blind biopsies and still this procedure required a pre -treatment with opiates for patients, despite this this system had a series of modifications in which Norbet Henning published color photographs and films of the films of theEndoscopic procedures.

In 1952, Fuji and the Olympus corporation created a gastrocámara, which was equipped with a photographic lens at the tip of the flexible tube, in which the images were captured in the form of monochromatic film manually activated and in 1957 they build the first fibroscope in thethat the era of optical fiber began as we know it today but that without a clutch it does not provide photographic images.

The fibroscope gastrocámara was created in 1964, in 1983 the videoendoscope and endoscope with ultrasound created by Sivak and Fleishner appears, in which through a chip it allows generating images achieving the projection in a TV monitor.

Paul C swaim in Great Britain presents an endoscopic capsule in 2001 and in 2002 an endoscopy system in HDTV or high definition technology was created;However, as time goes by technological and technical advances are of great range for society whose objective does not focus only on exploration but on the prevention, diagnosis and first -line therapeutic method in most gastrointestinal diseases, throughminimally invasive techniques.

Endoscopic advances

Endoscopy is a diagnostic technique based on the exploration of the inside of the organism through an optical system.

At present, there are several endoscopic modalities that allows us to explore the digestive system, thanks to the contributions generated by past times, of which several advances of techniques in endoscopy stand out:

• EDA: High digestive endoscopy, it is a new technique that allows the direct exploration of structures such as: esophagus, stomach and duodenum, through the endoscope. This instrument has an electronic image capture system reflected in a monitor, whose benefits allow to know the possibility of a large number of symptoms such as: abdominal pain, high digestive hemorrhage, polyps and/or tumors;However, in many cases the visualization is not only for the diagnostic purpose as in obtaining samples but also for a therapeutic purpose such as: placement of probes or prostheses for the treatment of a stenosis.(4) Illustration 1. Parts of the digestive tract valued with EDA. 
• FCS: Low digestive endoscopy, allows colon and rectum visualization through the colonoscope, which is introduced by the anal hole;However, during exploration, biopsies can be taken to complete the diagnosis and even removal of polyps, prosthetic placement, as therapeutic purpose. This technique needs a precise and aware preparation that the patient should follow such as: diet, oral laxative intake, fasting 2 to 4 hours before exams and other indications given by the doctor;This preparation is essential for the colon to be clean and allow its correct exploration.
• DES: Endoscopic dissection of the submucose, it is considered as a variant of the REM, in which a kind of endoscopic scalpel used to resect lesions in the submucosa is used. Due to the wide availability and low cost, saline so-lounge is the most used to raise the lesion. However, there are studies that show that the use of hypertonic undergoachieve it, since successive interruptions of the procedure for new elevations in the submucosa are not necessary. The main indications of the real. (7)
• POEM: Peroral endoscopic myotomy, surgical technique that is performed through a natural hole for the management of motor diseases such as achalasia, but it should be considered that it is an invasive procedure whose complication underlies a very esophageal perforation and sequence of producing medistianitis, sepsisand death, due to the incision in the mucosa and section of esophageal muscle fibers. This technique consists of 5 key characteristics for its realization:

1. Elevation of the esophageal mucosa
2. MUCOSA INCISION
3. Creation of the Submucoso Tunnel
4. Myotomy of the internal circular fibers of the esophageal wall, extending to the stomach;
5. Mucosa defect closure

• CPRE: Endoscopic retrograde cholangiopancreatography, derived from high endoscopy, is a technique combined with radiology that perides explore the duodenum and bile and pancreatic ducts and pancreatic ducts. This instrument is introduced through the mouth until reaching the duodenum or examination area, a probe is placed in the ducts and a contrast medium is injected to visualize said region, one of its benefits is to know the cause of symptoms related to bile pathologiesand pancreatic and lesions during exploration such as the presence of polyps, dilation, prosthesis placement.
• USE: endoscopic ultrasonography or ecoendoscopy, union between ultrasound and endoscopy, whose function is to visualize the interior of the digestive tract and other organs such as pancreas by means of an ultrasound system incorporated into the endoscope.

It will allow evaluating the causes of some symptoms related to digestive tract diseases as well as the statification of neoplastic lesions.

Can generate side effects after the rare procedure such as pain, bleeding, infection and perforations.

•  Cap or EMR-C: Transparent capsula or plastic capsule technique: it is a procedure in which endoscopic front vision techniques are used with the use of a transparent cap in the endoscope tip of the endoscope. This method consists of inserting the thin handle, pressed with the tip of the cap while the normal mucosa is aspirated through negative pressure, allowing the handle to be pre -installed in the cap, through it the mucosa is aspiring and strangled withThe handle. The absence of it and the resection size must be confirmed from the endoscopic point of view by means of a mucosectomy with high frequency electrocauterization.
•  Life: Endoscopic image by fluorescence, it is used as a mapping technique by means of contained endoscopes to a blue or white light source and reinterpret the signals through spectrometers, to detect dysplasias.
•  Endocythoscopy: It is a novel endoscopic technique of ultra high increase that allows the high quality in vivo quality evaluation of the lesions found in the gastrointestinal tract with the use of intraprocedural staining. The EC allows microscopic visualization of the surface of the gastrointestinal mucosa.

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