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Under the hood: introducing a new series for Gastrointestinal Endoscopy
UNDER THE HOOD
Under the hood: introducing a new series for Gastrointestinal Endoscopy Pankaj Jay Pasricha, MD Associate Editor for Under the Hood section, GIE
The first car I learned to drive was a Fiat 1100 (Fig. 1). It was a basic model: 4 gears and a reverse (manual of course), elegant in its simplicity, and as reliable as a trusted hound. Most importantly, I not only knew how to drive it but how to fix it, if anything went wrong. Indeed, looking under the hood was a reflex action for generations of drivers, and we were all familiar with the parts that faced us as well as the troubleshooting that could be expected. Apart from checking the oil and radiator water, there was the carburetor, which could be clogged with dirt, the electrical distributor, which could be loose, and the spark plugs, whose electrodes had to be cleaned with sandpaper and gaps manually adjusted. It was seldom that such efforts did not result in a return to the road and a successful completion of the planned tripdeven taking into account the many potholes that the monsoons inflicted on the surface! Similarly, the first endoscopes were elementary instruments that, conceptually, were extremely simple in operation (Figs. 2A and B). There were a limited number of parts and, consequently, only a few things that could go wrong. Early endoscopists potentially had the ability to take the scope apart and put it together again. Both cars and
Figure 1. The Fiat 1100, the author’s first car. Image from http:// www.starlinemodels.com/.
Copyright ª 2007 by the American Society for Gastrointestinal Endoscopy 0016-5107/$32.00 doi:10.1016/j.gie.2007.02.051
884 GASTROINTESTINAL ENDOSCOPY Volume 65, No. 6 : 2007
Figure 2. The gastrocamera (A), and gastrocamera tip structure (B). From The Olympus Corporation Webpage (http://www.olympus-global. com/en/corc/history/endo/), ‘‘The origin of endoscopes.’’
www.giejournal.org
Pasricha
Introducing a new series
endoscopes have, however, evolved tremendously. It can be argued that many of the changes have added to comfort, convenience, and speed, but not as much to the basic functionality (ie, getting from point A to B in a car or visualizing the mucosal surface with an endoscope). Despite my sentimentality, I would not trade my 2006 sedan for the Fiat nor revert to anything less than a slim videoendoscope in my clinical practice today. Advances in technology have, however, come at a price. It is no longer possible for us to perform anything more than the simplest form of troubleshooting in the machines and instruments we use both personally and professionally. Indeed, in many instances, we have even stopped teaching future generations how these instruments are made and how the component parts come together into a functional whole. Although we are not in a position to teach our readers about automobiles, the editors of this journal are enthusias-
tic about a series in which we can provide endoscopists with a ‘‘mechanic’s perspective’’ on the endoscopes, endoscopic devices, and accessories that they use on a daily basis. It is our belief that such practical knowledge of the engineering principles underlying the instruments can have multiple benefits for our readership. First, it will enhance their ability to troubleshoot technical problems. Second, they will obtain a better understanding of the limitations and safety features of the device. Finally, we hope that many of them will develop an appreciation of the technology development process and be personally encouraged to improve existing designs or come up with new devices altogether. In this regard, we have invited some of the leading and most creative minds in the field to write a series of articles on various devices and instruments, beginning with the basic platforms for visualization and moving on to specific therapeutic embodiments. I hope the readers will enjoy this series and learn from it as much as I have.
www.giejournal.org
Volume 65, No. 6 : 2007 GASTROINTESTINAL ENDOSCOPY 885
Under the hood: introducing a new series for Gastrointestinal Endoscopy Pankaj Jay Pasricha, MD Associate Editor for Under the Hood section, GIE
The first car I learned to drive was a Fiat 1100 (Fig. 1). It was a basic model: 4 gears and a reverse (manual of course), elegant in its simplicity, and as reliable as a trusted hound. Most importantly, I not only knew how to drive it but how to fix it, if anything went wrong. Indeed, looking under the hood was a reflex action for generations of drivers, and we were all familiar with the parts that faced us as well as the troubleshooting that could be expected. Apart from checking the oil and radiator water, there was the carburetor, which could be clogged with dirt, the electrical distributor, which could be loose, and the spark plugs, whose electrodes had to be cleaned with sandpaper and gaps manually adjusted. It was seldom that such efforts did not result in a return to the road and a successful completion of the planned tripdeven taking into account the many potholes that the monsoons inflicted on the surface! Similarly, the first endoscopes were elementary instruments that, conceptually, were extremely simple in operation (Figs. 2A and B). There were a limited number of parts and, consequently, only a few things that could go wrong. Early endoscopists potentially had the ability to take the scope apart and put it together again. Both cars and
Figure 1. The Fiat 1100, the author’s first car. Image from http:// www.starlinemodels.com/.
Copyright ª 2007 by the American Society for Gastrointestinal Endoscopy 0016-5107/$32.00 doi:10.1016/j.gie.2007.02.051
884 GASTROINTESTINAL ENDOSCOPY Volume 65, No. 6 : 2007
Figure 2. The gastrocamera (A), and gastrocamera tip structure (B). From The Olympus Corporation Webpage (http://www.olympus-global. com/en/corc/history/endo/), ‘‘The origin of endoscopes.’’
www.giejournal.org
Pasricha
Introducing a new series
endoscopes have, however, evolved tremendously. It can be argued that many of the changes have added to comfort, convenience, and speed, but not as much to the basic functionality (ie, getting from point A to B in a car or visualizing the mucosal surface with an endoscope). Despite my sentimentality, I would not trade my 2006 sedan for the Fiat nor revert to anything less than a slim videoendoscope in my clinical practice today. Advances in technology have, however, come at a price. It is no longer possible for us to perform anything more than the simplest form of troubleshooting in the machines and instruments we use both personally and professionally. Indeed, in many instances, we have even stopped teaching future generations how these instruments are made and how the component parts come together into a functional whole. Although we are not in a position to teach our readers about automobiles, the editors of this journal are enthusias-
tic about a series in which we can provide endoscopists with a ‘‘mechanic’s perspective’’ on the endoscopes, endoscopic devices, and accessories that they use on a daily basis. It is our belief that such practical knowledge of the engineering principles underlying the instruments can have multiple benefits for our readership. First, it will enhance their ability to troubleshoot technical problems. Second, they will obtain a better understanding of the limitations and safety features of the device. Finally, we hope that many of them will develop an appreciation of the technology development process and be personally encouraged to improve existing designs or come up with new devices altogether. In this regard, we have invited some of the leading and most creative minds in the field to write a series of articles on various devices and instruments, beginning with the basic platforms for visualization and moving on to specific therapeutic embodiments. I hope the readers will enjoy this series and learn from it as much as I have.
www.giejournal.org
Volume 65, No. 6 : 2007 GASTROINTESTINAL ENDOSCOPY 885