Gastroscopy with biopsy and cytological sampling under direct vision.

Gastroscopy has improved with the introduction of fibre-optics. The flexible fibrescope allows inspection of the stomach with much less discomfort to the patient than earlier gastroscopes, which are flexible only through part of their length. The value of gastroscopy is greatly enhanced if lesions can be hiopsied while being inspected. This has been achieved in the past for semi-rigid gastroscopes by several workers (Kenamore, 1940; Benedict, 1948; Debray and Housset, 1959), but has only recently been developed for the fibrescope. This model is the Olympus G.F.B. combined fibrescope and gastrocamera, which incorporates a method of obtaining histological and cytological specimens under direct vision. This paper reports our initial experiences with this instrument. The first three authors carried out the gastroscopic examinations and the other two were responsible for the histological and cytological studies respectively. It has been the usual practice for at least two of the gastroscopists to examine the stomach in every patient; this has helped to diminish observer error.