Taking a peek inside the gallbladder to see how many stones were there and if it needed removal. Having a direct view of the total intestinal canal to make sure there were no sinister lumps or growths needing removal. Looking directly inside the stomach to check the reason for recurring pain or bleeding.
If this all sounds a little weird, you’re right. But the fact is these strange procedures are being carried out by surgeons right now.
An astounding stride forward has suddenly taken place in the medical world. It concerns a fascinating invention called the fibrescope.
With this ingenious device, surgeons can now look directly into the remotest parts of the human system. The horizons for the future are bounded only by human imagination.
The clinical applications are enormous, and major surgery is being avoided as an accurate diagnosis is now possible using this relatively simple procedure. This means lengthy stays in hospital can often be avoided.
A fibrescope is an instrument that operates through the properties of a bundle of extremely fine glass fibers. These fibers have the uncanny ability of carrying images around corners.
When hooked up to a viewing system, the fibers transmit a light to the part under examination. By looking into the viewing end, the surgeon can then gain a direct picture of the part into which the far end of the scope is placed.
The instruments are very flexible. They are also quite thin, often only a few millimeters in diameter. For this reason, they are extremely maneuverable and can gain access into nearly any aperture located almost anywhere in the body. Provided it is connected to a system that is accessible, there is no limit to the areas into which the scope may penetrate.
Until recently, standard examinations used rigid instruments that were able to penetrate only certain organs. For example, the bronchoscope gave a view of the major passages of the lungs. The gastroscope could look into the stomach. The sigmoidoscope enabled examination of the lower part of the bowel.
But the highly flexible instruments now in use can be bent into any shape. So they can dig deeper and deeper, revealing an increasing wealth of important data.
In many areas, they have almost entirely replaced the X-ray. Rays depend on shadows being cast onto a sensitive film, and the expert tries to read and interpret these. Naturally, there are many misses and inaccurate diagnoses.
In sharp contrast, the fibrescopes look directly at the organ. The disease can be readily and accurately picked up.
Apart from pinpointing the diseased spot, treatment sometimes can be carried out by side arms earning special equipment. This treatment is done under the direct view of the surgeon.
To date, the chief application has been the diagnosis and removal of small, meaty growths from the wall of the colon (large bowel). These are called polyps and are often the precursor of rectal cancer. These are removed for later examination under the microscope for an accurate diagnosis. Growths that could have developed into cancer are thus stopped short before any harm can take place.
With cancer of the digestive system (of which the colon forms a significant part) killing over 11,000 Americans annually, this is a significant contribution.
Bleeding from the stomach or duodenum is often due to a peptic ulcer, but there are other important causes. X-ray examination was the usual diagnostic tool. But the fibrescope is rapidly replacing this. It pinpoints the bleeding spot accurately and promptly and is used routinely in many major hospitals now. Smaller bleeding parts may also be treated by this instrument.
Many pregnant wombs have already been examined under the fibrescope. With more and more emphasis being placed on checking the developing baby for possible defects, or blood disorders, it seems this may be one relatively simple way of obtaining fetal blood specimens.
Untold thousands of people suffer from gall-stones, and as yet surgery is still the main method of relief. However, stones have now been removed by the fibrescope. It may not be suitable for all cases, but it may be used to treat many as expertise increases.
Strictures in various parts of the system also may be treated by the new device. The liver and the pancreatic glands can be searched for abnormalities. Valves and interiors of the heart chambers also can be explored, and doctors even can look directly into the cavities of the brain in search of a disease.
The scopes are extremely expensive, costing thousands of dollars. They must be serviced and cared for with extreme care and skill. Breakdowns are frequent, repairs expensive.
In many areas, certain doctors seem to be acquiring a special facility for handling these instruments, and there is even talk of a sub-specialty arising for the procedure. The greater experience the surgeon has, the more facile he naturally becomes and the quicker and more accurate are his diagnoses.
Today, with soaring medical costs, cost-effectiveness is being studied more and more. It seems a good case can be made out for this major advance. By diagnosing cases quicker, and with less major surgery, the unit cost drops sharply. Bed wastage is reduced and turnover increased.
The fibreoptics revolution has come to stay.