A History of Flexible Gastrointestinal Endoscopy.

Surgeons have been involved, since the beginning, in the development and evolution of endoscopy. They have been instrumental in developing new methods and have been actively involved in most of the therapeutic applications. The continued evolution of endoscopic technique is inevitable and will involve the integration of new technology with innovative thinking.

History of endoscopic devices for the exploration of the small bowel.

The small bowel has gained new attention since the development of the wireless videocapsule in 2000, opening up the last 'black box' of the gastrointestinal tract. Although conventional push enteroscopy has been available for decades, since the wireless videocapsule new enteroscopes have been developed to examine the entire small bowel endoscopically in order to perform all conventional endoscopic procedures. The present review highlights the historic evolution of enteroscopy, from the first complete enteroscopy in 1971 over the current balloon-assisted and over-tube-guided methods of enteroscopy to future directions of evolutions towards perfection.

George Berci: past, present, and future.

Dr. George Berci's contributions to the art and science of endoscopy and laparoscopy have continued unabated for nearly half a century. Fundamental advances in optics, illumination, television application, instrumentation, and operative radiology were either fostered or initiated by him, culminating in the advanced state of the technology as it is known today. As a creative force and catalytic influence, he has been a true pioneer.

[How endoscopy has changed in recent 60 years]. / Jak se zmenila endoskopie za posledních 60 let.

Sixty years ago only semi flexible instruments were used for the endoscopic examination of the gastrointestinal tract. They were developed by the German physician Rudolf Schindler together with George Wolf, the producer of medical instruments in 1932. They construct optical gastroscope with a system of lenses in the flexible distal end and with the rigid metallic proximal part. Those instruments were used in gastroscopy till the sixties when the era of fibroendoscopy with the use of glass fibre optic has started. In 1957 Basil Hirschowitz with his co-workers introduced a flexible gastroscope--a fibroscope. The next years brought improvement in the size of image, its brilliancy, possibility to control the distal end and a bioptic channels was added. Working length was elevated and since 1970 the instrument has been used as ezofago-gastro-duodenoscope. At the end of millennium a new technology was developed--videoendoscopy. Experience with the prototype of videoendoscope was published in 1984 (Sivak a Fleischer, Classen a Phillip). In the nineties of the previous century Paul Swain constructed the first prototype of wireless endoscopic capsule. A single chip camera with low electricity consumption was presented in 2000. Endoscopy has developed in recent years considerably and its progress will definitely continue.

Digestive endoscopy from rigid to fiber-optic instruments; the Polish contribution to the development of gastrointestinal endoscopy.

In 1987 on the occasion of the 50(th) anniversary of the British Society of Gastroenterology Sir Francis Avery-Jones (1) wrote (perhaps a little exaggerating) in his introductory remarks: "In 1937 the alimentary tract was invisible, impalpable and inaccessible-except the top and the bottom". Indeed, diagnostics in gastroenterology was very weak and uncertain at the beginning and even in the middle of the last century. Endoscopy and radiology, developing first apart and then together revolutionized the diagnostics and consequently the practice in gastroenterology. Endoscopy brought a new access to operative procedures alleviating the burden of open surgery as well. The method, apart from knowledge, needs personal skills and so new problems of postgraduate education and ethics appeared. Due to the enormous progress in science and in technology it has reached the present level of accuracy. Polish gastroenterology with its early achievements in gastric secretion (Leon Popielski, histamine), abdominal surgery (Ludwik Rydygier, first gastric resection), endoscopy (Jan Mikulicz-Radecki) and later research upon the neuro-hormonal brain-gut axis (Stanislaw J. Konturek) tried to keep pace with the world-wide progress in this field. The Polish contributions to the growing knowledge and improving practice may be traced from the very beginning of the 20(th) century.