Milestones in endoscope design for minimally invasive urologic surgery: the sentinel role of a pioneer

Abstract

Endoscopically based techniques have revolutionized the entire field of surgical specialties over the past 50 years. Currently, minimal access surgery is commonplace for considerable segments of surgical procedures across specialty lines. Central to this revolution, and arguably foremost in its impact on the development of minimally invasive endoscopic surgery, was the development of the rod-lens optical system by Professor Harold H. Hopkins and the almost simultaneous development of the fiberoptic cold-light light source by Karl Storz. It was George Berci who acted as the catalyst in bringing these two men together in the early 1960s, and from that meeting ensued one of the most successful cooperations in the design of endoscopic equipment. Innovative surgeons quickly recognized the enormous potential of these inventions, and in this context, George Berci's work and vision provided the hallmark events leading to the clinical applications from which surgeons and their patients so greatly benefit currently. In urology, Berci's early work has been recognized as a sentinel event bringing endoscopic endoluminal surgery from the lower urinary tract (urethra, bladder, prostate) to the upper urinary tract (ureter, kidney), and eventually to extraluminal laparoendoscopic surgery. This work has been recognized by the Journal of Urology as a "milestone in urology" leading to the clinical application in the field of endoscopic surgery currently referred to as endourology. In this article, the current state-of-the-art urologic surgery for the management of stone disease, urologic tumors, and anatomic abnormalities is presented, which to a great extent has its roots in George Berci's contributions to the field of innovative endoscope design.

Two decades of minimally invasive pediatric surgery—taking stock

“…Lack of technology to adequately miniaturize the instruments was a serious limitation for pediatric use [4]. The introduction of the Hopkins rod lens system and the Storz cold fiber-optic light source in the 1960s was a technological breakthrough that would pave the way for laparoscopy to be integrated into medicine [13,14]. Armed with these innovations that made it possible to miniaturize instruments for use in children, there was a renewal of interest for laparoscopy in children [4].…”

Can endourology fellowship training enhance minimally invasive surgery in urology practice?

“…The collaboration of Harold H. Hopkins, Karl Storz and George Berci in the technology and design of endoscopic equipment facilitated the growth endoscopic surgery, which was recognised by the Journal of Urology as a ‘milestone in urology’ leading to the field known as ‘Endourology’ [1]. Endourology has since become an established subspecialty in urology.…”

“…Endourology has since become an established subspecialty in urology. The terminology was popularised by pioneers who founded the Endourological Society in 1984 [1]. This subspecialty utilises most of the advanced technology in urology including ureteroscopy (URS), percutaneous renal surgery, laparoscopy, laser technology, shockwave lithotripsy, and recently robot-assisted surgery.…”

In-vivo pan/tilt endoscope with integrated light source

“…However, this new technique drastically increases the complexity of a surgeons' operation because of the rigid, sticklike instruments, impaired depth perception, loss of sense of touch and the difficulty in varying the perspective view of the operative field [1]. As a critical imaging device, the basic architecture of the endoscope has not been fundamentally changed since the invention of the rod-lens by Hopkins and cold light source of fiber optics by Karl Storz in 1950's [2]. Traditional endoscope uses the fiber-optics to deliver the light into the abdomen and the rodlens to transmit the image back to the CCD camera sensor.…”