With the help of an optical fiber and a digital photography system, it is now possible to reach most of the body's organs and reveal its secrets
By: Yoel Donhin *
From the movie "The Amazing Journey" according to Asimov. The team fights the blood clots
"The Amazing Journey", the science fiction story written by Isaac Asimov, was adapted into a film of the same name. The story is not convincing - after a car accident, blood clots remained in the brain of an important scientist and it was necessary to save him no matter what. The technology exists and you just have to try it. A medical team, which also included actress Raquel Walsh, was shrunk and sat inside a submarine the size of a bacterium. This device was inserted into the patient's arteries and the team had to reach upstream into the brain tissue and precisely activate a laser cannon that would dissolve the clot. After that, the team, who was in dire danger (the antibodies in the body would recognize it as a foreign body and eat it alive), had to quickly get away from the body. With great joy they were saved at the last moment, the submarine is swept away in the liquid of tears and the end is really not important.
In this wonderful cinematic journey inside the body, we saw from inside the submarine the large red blood cells, the walls of the arteries and the heart valves that close forcefully and do not allow proper passage into the small submarine. In 1966 it was science fiction. Today the fiction has become reality. Although there is no miniaturized submarine, it is certainly possible to swallow a bullet with a camera in it, which descends leisurely into the esophagus and digestive tract and transmits its findings in colors directly to the receiving devices of the examining doctor, until it is flushed out of the toilet at the end of the journey.
The desire to look into the body's cavities already existed with the father of medicine, Hippocrates. With the means he created himself it was possible to look into the anus and its immediate surroundings. The first to use lighting for observation purposes was Arnazi in 1585. He wanted to look directly into the nasal cavities and used a mirror system that transmitted the light into the nostrils. A similar system is used by otolaryngologists to cast a beam of light into the back of the pharynx and the depths of the throat. The round mirror with a hole in the center is a medical symbol no less than the reflex hammer. In 1806, Philip Bozeny built a rather sophisticated device for the purpose of observing the urinary system. As a light source, use a lighted candle and an optical system. The candle that heated its surroundings resulted in some complications as a result of contact with the hot device, but there is no doubt that this was a serious advance.
It wasn't until 1853 that Antoine Jean Desormeaux built a device that made it possible to penetrate the urinary system and the digestive system. This time the light source was stronger but no less dangerous. The possibility of entering the space and seeing what was happening inside it was very magical; It must be remembered that in those distant days it was not yet possible to take an X-ray and everything that was hidden under the skin was a mystery like no other. The possibility to observe and diagnose a stone blocking the opening of the bladder was an unimaginable advance. Other landmarks indicate that the desire was there and it was necessary to wait for technology to help. Quite cumbersome instruments have been developed to look at the esophagus on the one hand and the lower part of the digestive system on the other hand.
It wasn't until 1911 that a doctor at Johns Hopkins Hospital in Baltimore inserted a metal tube about a centimeter in diameter into the abdominal cavity. An ordinary light bulb illuminated the space. Gradually, means were developed to penetrate the body cavities and the limiting factor was the observation possibilities in the surgical field. The surgeons had to look at the body cavities they penetrated as if they were looking through monocular binoculars.
The infinite possibilities began to be realized only when it was possible to use an optical fiber that transmits an image that is captured by a tiny video camera connected to a screen and allows to see in precious light, a clear and magnified image of the area where the surgeon performs his work. The surgeons adapted to the new way with incredible speed. They learned to work with devices they were not used to, to observe the large screen placed in front of them, to see every tiny movement magnified dozens of times. And not only the surgeon could see what was happening, but every member of the team in the operating room followed what was happening. It was possible to record the surgery on film and even give it to the surgeon (so that he could show his gallbladder removal to his friends on Shabbat night, for example). Modern operating rooms have been rebuilt so that the screens can be placed in front of the surgeon's eyes and at the appropriate height.
Advertisement In fact, today it is possible to reach most of the body's organs with the help of an optical fiber and a digital photography system. The doctors can pass a thin tube through the nose to the throat, find out the condition in the nasal cavities, penetrate into the lung through the bronchi, observe and take samples from the abdominal organs, find out in a short time the condition of the woman's ovaries, fallopian tubes and reproductive organs, penetrate through the urethra and urinary tract up to the renal pelvis , operate a gun powered by sound waves and break up stubborn kidney stones. The joints of the body were also exposed to the orthopedist's camera, which is able not only to see the ligaments that hold the joint but also to sew and standardize them.
Even the anatomy books have become a little outdated because the apprentice student can see with his own eyes the organs of the body in their healthy, natural state, when the blood flows in the arteries and veins and the system works as a miraculous organism.
The wonderful journey gradually turned into a day-to-day action, the secrets of the body are exposed to the camera's eye. The last frontier that we cannot yet penetrate by optical means is the human soul - and here the fiction continues.
* The writer is a specialist in anesthesia at Hadassah Hospital in Jerusalem
