Editing Endoscope (section)

== History ==
[[File:Bozzini's_Lichtleiter.svg|thumb|Drawings of Bozzini's "Lichtleiter", an early endoscope]]
The first endoscope was developed in 1806 by German [[physician]] [[Philipp Bozzini]] with his introduction of a "Lichtleiter" (light conductor) "for the examinations of the canals and cavities of the human body".<ref>{{cite journal |last1=Bozzini |first1=Philipp |year=1806 |title=Lichtleiter, eine Erfindung zur Anschauung innerer Teile und Krankheiten, nebst der Abbildung |trans-title=Light conductor, an invention for examining internal parts and diseases, together with illustrations |url={{Google books|dn8tAAAAcAAJ|page=107|plainurl=yes}} |journal=Journal der Practischen Arzneykunde und Wundarzneykunst |language=de |volume=24 |pages=107–24}}</ref> However, the [[Gesellschaft der Ärzte in Wien|College of Physicians in Vienna]] disapproved of such curiosity.<ref>{{Cite book |last=Yamada |first=Tadataka |url=https://books.google.com/books?id=U6BdMMytieQC&q=first+endoscope+developed+in+1806&pg=PA884 |title=Atlas of Gastroenterology |date=2009-01-22 |publisher=John Wiley & Sons |isbn=978-1-4443-0342-1 |name-list-style=vanc}}</ref> The first effective open-tube endoscope was developed by French physician [[Antonin Jean Desormeaux]].<ref>{{Cite web |title=Desormeaux, Antonin Jean |url=https://history.uroweb.org/biographies/desormeaux-antonin-jean/ |access-date=2022-06-29 |website=EAU European Museum of Urology |language=en-GB}}</ref> He was also the first one to use an endoscope in a successful operation.<ref name="auto">{{Cite journal |last=Janssen |first=Diederik F |date=2021-05-17 |title=Who named and built the Désormeaux endoscope? The case of unacknowledged opticians Charles and Arthur Chevalier |url=http://journals.sagepub.com/doi/10.1177/09677720211018975 |journal=Journal of Medical Biography |language=en |volume=29 |issue=3 |pages=176–179 |doi=10.1177/09677720211018975 |issn=0967-7720 |pmid=33998906 |s2cid=234747817|url-access=subscription }}</ref>

After the invention of [[Thomas Edison]], the use of electric light was a major step in the improvement of endoscope. The first such lights were external although sufficiently capable of illumination to allow cystoscopy, hysteroscopy and sigmoidoscopy as well as examination of the nasal (and later thoracic) cavities as was being performed routinely in human patients by [[Sir Francis Cruise]] (using his own commercially available endoscope) by 1865 in the [[Mater Misericordiae University Hospital|Mater Misericordiae Hospital]] in Dublin, Ireland.<ref>{{cite journal |vauthors=Caniggia A, Nuti R, Lore F, Martini G, Turchetti V, Righi G |date=April 1990 |title=Long-term treatment with calcitriol in postmenopausal osteoporosis |journal=Metabolism |volume=39 |issue=4 Suppl 1 |pages=43–9 |doi=10.1136/bmj.1.223.345 |jstor=25204557 |pmc=2325571 |pmid=2325571}}</ref> Later, smaller bulbs became available making internal light possible, for instance in a [[Hysteroscopy|hysteroscope]] by Charles David in 1908.<ref>{{cite book |last1=Shawki |first1=Osama |url=https://books.google.com/books?id=0SYLDgAAQBAJ&pg=PA13 |title=Mastering the Techniques in Hysteroscopy |last2=Deshmukh |first2=Sushma |last3=Pacheco |first3=Luis Alonso |publisher=Jaypee Brothers Medical Publishers |year=2017 |isbn=978-93-86150-49-3 |pages=13– |name-list-style=vanc}}</ref>

[[Hans Christian Jacobaeus]] has been given credit for the first large published series of endoscopic explorations of the abdomen and the thorax with [[Laparoscopy|laparoscope]] (1912) and [[Thoracoscopy|thoracoscope]] (1910)<ref name="pmid9876654">{{cite journal |vauthors=Litynski GS |date=Jan–Mar 1997 |title=Laparoscopy—the early attempts: spotlighting Georg Kelling and Hans Christian Jacobaeus |journal=JSLS |volume=1 |issue=1 |pages=83–5 |pmc=3015224 |pmid=9876654}}</ref> although the first reported thoracoscopic examination in a human was also by Cruise.<ref>{{cite journal |last1=Gordon |first1=Samuel |name-list-style=vanc |year=2014 |title=Art. VIII.—Clinical reports of rare cases, occurring in the Whitworth and Hardwicke Hospitals |url=https://zenodo.org/record/1865816 |journal=Dublin Quarterly Journal of Medical Science |volume=41 |issue=1 |pages=83–99 |doi=10.1007/BF02946459}}</ref>

Laparoscope was used in the diagnosis of [[liver]] and [[gallbladder]] disease by Heinz Kalk in the 1930s.<ref>{{cite book |last1=Wildhirt |first1=Egmont |title=Neue Deutsche Biographie (NDB). Band 11 |last2=Kalk |first2=Heinrich-Otto |date=1977 |publisher=Duncker & Humblot |isbn=978-3-428-00192-7 |location=Berlin |page=60 |name-list-style=vanc}}</ref> Hope reported in 1937 on the use of laparoscopy to diagnose [[ectopic pregnancy]].<ref>{{cite book |url=https://books.google.com/books?id=pCUgAwAAQBAJ&pg=PA131 |title=Paediatric and Adolescent Gynaecology: A Multidisciplinary Approach |vauthors=Balen AH, Creighton SM, Davies MC, MacDougall J, Stanhope R |date=2004-04-01 |publisher=Cambridge University Press |isbn=978-1-107-32018-5 |pages=131–}}</ref> In 1944, [[Raoul Palmer]] placed his patients in the [[Trendelenburg position]] after gaseous distention of the abdomen and thus was able to reliably perform [[Gynecology|gynecologic]] laparoscope.<ref name="Litynski_1997">{{cite journal |vauthors=Litynski GS |date=Jul–Sep 1997 |title=Raoul Palmer, World War II, and transabdominal coelioscopy. Laparoscopy extends into gynecology |journal=Journal of the Society of Laparoendoscopic Surgeons |volume=1 |issue=3 |pages=289–92 |pmc=3016739 |pmid=9876691}}</ref>

Georg Wolf, a Berlin manufacturer of rigid endoscopes established in 1906, produced the Sussmann flexible gastroscope in 1911.<ref>{{cite web |title=About Richard Wolf Germany |url=https://www.richardwolfusa.com/company/100-years-of-innovation.html |publisher=Richard Wolf Medical Instruments}}</ref><ref>{{cite web |title=Endoscope Biopsy channels|url=https://smarttechmed.com/endoscope-biopsy-channels/|publisher=Richard Wolf Medical Instruments}}</ref> [[Karl Storz SE|Karl Storz]] began producing instruments for [[Otolaryngology|ENT]] specialists in 1945 through his company, [[Karl Storz GmbH]].<ref>{{cite web |last1=Nezhat |first1=Camran |name-list-style=vanc |date=2005 |title=Chapter 19. 1960's |url=http://laparoscopy.blogs.com/endoscopyhistory/chapter_19/index.html |url-status=dead |archive-url=https://web.archive.org/web/20180727115326/http://laparoscopy.blogs.com/endoscopyhistory/chapter_19/index.html |archive-date=2018-07-27 |access-date=2016-01-07 |work=Nezhat's History of Endoscopy |publisher=Society of Laparoendoscopic Surgeons}}</ref>

=== Fiber optics ===
[[File:Storz_Endoscopy_Unit.png|thumb|A Storz endoscopy unit used for [[laryngoscopy]] exams of the [[vocal folds]] and the [[glottis]]]]
[[Basil Hirschowitz]], Larry Curtiss, and Wilbur Peters invented the first fiber optic endoscope in 1957.<ref name="pmid2044933">{{cite journal |vauthors=Edmonson JM |date=March 1991 |title=History of the instruments for gastrointestinal endoscopy |journal=Gastrointestinal Endoscopy |volume=37 |issue=2 Suppl |pages=S27–56 |doi=10.1016/S0016-5107(91)70910-3 |pmid=2044933}}</ref> Earlier in the 1950s [[Harold Hopkins (physicist)|Harold Hopkins]] had designed a "fibroscope" consisting of a bundle of flexible glass fibres able to coherently transmit an image. This proved useful both medically and industrially, and subsequent research led to further improvements in image quality.

The previous practice of a small filament lamp on the tip of the endoscope had left the choice of either viewing in a dim red light or increasing the light output – which carried the risk of burning the inside of the patient. Alongside the advances to the optics, the ability to 'steer' the tip was developed, as well as innovations in remotely operated surgical instruments contained within the body of the endoscope itself. This was the beginning of "key-hole surgery" as we know it today.<ref>{{Cite journal |last=Sun |first=Guoging |display-authors=etal |date=January 2019 |title=Comparison of keyhole endoscopy and craniotomy for the treatment of patients with hypertensive cerebral hemorrhage |journal=Medicine |location=Baltimore |volume=98 |issue=2 |page=e14123 |doi=10.1097/MD.0000000000014123 |pmc=6336657 |pmid=30633227 |doi-access=free}}</ref>

=== Rod-lens endoscopes ===
There were physical limits to the image quality of a fibroscope. A bundle of 50,000 fibers would only give a 50,000-pixel image, and continued flexing from use breaks fibers and progressively loses pixels. Eventually, so many are lost that the whole bundle must be replaced at a considerable expense)
. [[Harold Hopkins (physicist)|Harold Hopkins]] realised that any further optical improvement would require a different approach. Previous rigid endoscopes suffered from low light transmittance and poor image quality. The surgical requirement of passing surgical tools as well as the illumination system within the endoscope's tube which itself is limited in dimensions by the human body left very little room for the imaging optics.{{citation needed|date=July 2022}} The tiny lenses of a conventional system required supporting rings that would obscure the bulk of the lens' area. They were also hard to manufacture and assemble and optically nearly useless.{{citation needed|date=July 2022}}

The elegant solution that Hopkins invented was to fill the air-spaces between the 'little lenses' with rods of glass. These rods fitted exactly the endoscope's tube making them self-aligning and requiring of no other support.{{citation needed|date=July 2022}} They were much easier to handle and utilised the maximum possible diameter available.

With the appropriate curvature and coatings to the rod ends and optimal choices of glass-types, all calculated and specified by Hopkins, the image quality was transformed even with tubes of only 1mm in diameter. With a high quality 'telescope' of such small diameter the tools and illumination system could be comfortably housed within an outer tube. Once again, it was Karl Storz who produced the first of these new endoscopes as part of a long and productive partnership between the two men.<ref>{{cite web |title=History |url=http://www.haroldhopkins.org/history.html |work=Harold Hopkins Society}}</ref>

Whilst there are regions of the body that will always require flexible endoscopes (principally the gastrointestinal tract), the rigid rod-lens endoscopes have such exceptional performance that they are still the preferred instrument and have enabled modern key-hole surgery.{{citation needed|date=July 2022}} (Harold Hopkins was recognized and honoured for his advancement of medical-optic by the medical community worldwide. It formed a major part of the citation when he was awarded the Rumford Medal by the Royal Society in 1984.)