Gastroscopy: A Survey

Gastroscopy is the latest endoscopic method to become established by achieving safety combined with useful vision, and yet it was one of the earliest attempted. In 1868, only five years after Desormeux had invented a method of illuminating an endoscope, Kussmaul1 published in Freiburg his attempt to examine the stomach of a professional sword swallower. His method was to pass a long straight metal tube (47cm. long and 13mm. diameter) over a previously introduced flexible obturator but the primitive method of illumination was insufficient. The first useful views of the interior of the stomach were obtained in 1881 by Mikulicz2 using an angled rigid gastroscope with illumination at its distal end by means of a small electric bulb?then a recent innovation. This method was abandoned because of its technical difficulties and fatalities following its use. Later, attempts to make a flexible jointedgastroscope which could be made rigid and straight after introduction were made, and abandoned. Perhaps the first routinely used gastroscope was the rigid closed tube with a long rubber tip (which facilitated passage through the lower oesophagus) introduced by Eisner3 in 1911. Again the disadvantage was that fatalities occurred in all but one or two very