Collecting and Recollecting: Medical Museum: University of Iowa Health Care: Gifts from the Recent Past

Collecting and Recollecting: Gifts from the Recent Past

Gastroscopy

Gastroscopy enables the physician to see the surface of interior cavities of the body, specifically, the stomach and upper intestinal regions. The tubular instrument is inserted into the mouth and is held there until the throat muscles open to let it pass through. Sometimes the patient may be asked to swallow to encourage the muscles to open. Once it passes the throat, the gastroscope's smooth surface allows it to slide down the esophagus easily with little discomfort to the patient. The first gastroscopic experiments were performed in the 1850's on sword swallowers. Until Thomas Edison invented the light bulb in 1881, gastroscopes used candlelight or flammable liquids such as alcohol or turpentine as sources of light. When Max Nitze miniaturized the light bulb, a new era of gastroscopy began.

In the 1930's, Germany was the leader in optical research and technology and the foremost manufacturer of gastroscopes, microscopes and other medical equipment. By the late 1950's, American manufacturers were making quality optical equipment using the new fiber-optic technology.

Currently, the flexible gastroscopes used at The University of Iowa Hospitals and Clinics are very similar in appearance to the 1950's fiber-optic models. However, a computer chip is now installed at the tip of the gastroscope to transmit the image to a video screen so the procedure can be observed by the patient, physicians and technicians.

Gastric suction pump
Manufactured by V. Mueller and Co., Chicago
circa 1930

Gastric suction pumps are used to empty patients' stomachs in preparation for surgery and in emergency treatment. George Garwood, RN, worked as a nurse and nurse administrator in the 1940's and 50's and remembers similar suction pumps on every ward.

Gift of George J. Garwood, RN, Vinton, Iowa.
In memory of Charles Manahan, MD

Gastroscope
Manufactured by G. Wolf, Berlin
circa 1932

Dr. Rudolph Schindler and optical physicist Georg Wolf, both Germans, designed a flexible scope that provided a clear image and replaced the rigid and uncomfortable scopes in use since the nineteenth century. A series of prisms concealed in the flexible coil-lining of the lower end of the scope transferred the image of the stomach wall up to the eyepiece.

The Wolf-Schindler scope consisted of a guiding tip which directed the scope's insertion and movement within the esophagus and stomach, an air balloon to expand the stomach for easier viewing, and a miniature light bulb just above the tip to illuminate a section of the stomach wall and small intestine. Finally, an angled mirror reflected the image onto a lens and directed it to the prism series, allowing the operator a view of the internal organs.

The scope on display here is basically the Wolf-Schindler model described above, with slight modifications. This scope was discarded because the ball tip neither guided nor balanced the instrument well along the stomach wall. Also, the bulging lamp which protruded beyond the lens to provide adequate light sometimes became caught on the stomach lining.

This model was used in the United States soon after its invention, foreshadowing the rapid acceptance and popularity of German-made optical instruments.

Given in memory of W.D. Paul, MD

Wolf Gastroscope
circa 1940

Dr. D.W. Paul introducing the gastroscope with the assistance of Dr. Lewis January.

Medical Museum archives

Rigid Gastroscope
metal
circa 1870

This rigid gastroscope is typical of those used until the semi-flexible design of Georg Wolf and Rudolph Schindler in 1932.

Gastroscopy. R. Schindler, p.3

Gastroscope (ACMI)

This drawing shows the arrangement of the interior accessories of the fibre-optic gastroscope.

The Way Things Work. D. Macauley, p.197

Flexible Gastroscope
Manufactured by American Cystoscope Makers, Inc.
circa 1960

This was the first flexible gastroscope to be used at The University of Iowa Hospitals and Clinics. It reflects the technical advances made in gastroscopy in the United States within twenty years of the introduction of the German-made "Wolf-Schindler" gastroscope in the 1930's. Responsible for its success was South African-born Basil Hirschowitz, who helped develop fiber-optic endoscopy in 1958.

Fiber-optic technology employs dense bundles of glass fibers which transmit brilliant light and return a sharp image to the viewer, even at a 360-degree bend. This flexibility provides increased comfort for the patient and easier insertion for the doctor. The whole process takes from 15 minutes to 1 hour, depending on the work being done and the area being viewed.

When the prism construction of the older model was replaced with fiber-optic technology, the scope became fully flexible and maneuverable. The guiding tip, which moved only forward and backward in the older model, was equipped with controlling wires to allow a wider range of motion and exploration. Extra room inside the tube held accessories used for suction, insufflation of air and passage of biopsy forceps, cytology brushes and snares.

Gift of the Department of Surgery, UIHC

Last modification date: Thu Jul 6 15:18:47 2006
URL: http://www.uihealthcare.com /depts/medmuseum/galleryexhibits/collectingfrompast/gastro/gastroscopy.html