Struggling toward easier endoscopy

Gastrointestinal endoscopy has undergone tremendous evolution since the development of fiberoptics by Sir Anthony Hopkins1 and its incorporation into flexible endoscopes by Basil Hirschowitz.2 Initially, flexible endoscopy was perceived as a diagnostic tool and in its earliest form was capable only of capturing still photographs (gastrocamera).3 Rapidly, however, the cry went out to develop biopsy forceps to obtain mucosal biopsies for histologic evaluation. Colonoscopy was a natural extension of upper endoscopy, but it became immediately apparent that “visualization” alone was insufficient and that “intervention” in the form of polypectomy needed to be an integral part of this procedure.