At about the same time as the invention of the operating microscope, a British researcher named Harold Hopkins helped perfect two devices that further revolutionized surgeons' work: the fiber-optic endoscope and the laparoscope. Both are hollow tubes containing a fiber-optic cable that allows doctors to see and work inside the body without opening it up. Endoscopes, which are flexible, can be fed into internal organs such as the stomach or intestines without an incision and are designed to look for growths and other anomalies. Laparoscopes are rigid and require a small incision, but because they are stiff, they enable the surgeon to remove or repair internal tissues by manipulating tiny blades, scissors, or other surgical tools attached to the end of the laparoscope or fed through it. Further advances in such minimally invasive techniques began to blur the line between diagnosis and treatment. In the 1960s a radiologist named Charles Dotter erased that line altogether when he developed methods of using radiological catheters—narrow flexible tubes that can be seen with imaging devices—not just to gain views of blood vessels in and around the kidney but also to clear blocked arteries. Dotter was a tinkerer of the very best sort and was constantly inventing his own equipment, often adapting such unlikely materials as guitar strings, strips of vinyl insulation, and in one case an automobile speedometer cable to create more effective interventional tools.
Adaptation was nothing new in medicine, and physicians always seemed ready to find new uses for technology's latest offspring. Lasers are perhaps the best case in point. Not long after its invention, the laser was taken up by the medical profession and became one of the most effective surgical tools of the 20th century's last 3 decades. Lasers are now a mainstay of eye surgery and are also routinely employed to create incisions elsewhere in the body, to burn away growths, and to cauterize wounds. Set to a particular wavelength, lasers can destroy brain tumors without damaging surrounding tissue. They have even been used to target and destroy viruses in the blood. Adaptation was nothing new in medicine, and physicians always seemed ready to find new uses for technology's latest offspring. Lasers are perhaps the best case in point. Not long after its invention, the laser was taken up by the medical profession and became one of the most effective surgical tools of the 20th century's last 3 decades. Lasers are now a mainstay of eye surgery and are also routinely employed to create incisions elsewhere in the body, to burn away growths, and to cauterize wounds. Set to a particular wavelength, lasers can destroy brain tumors without damaging surrounding tissue. They have even been used to target and destroy viruses in the blood. As surgeons recognized the benefits of minimally invasive procedures, which dramatically reduce the risk of infection and widen the range of treatment techniques, they also became aware that they themselves were now a limiting factor. Even with the assistance of operating microscopes attached to laparoscopic tools, surgeons often couldn't move their hands precisely enough. Then in the 1990s researchers began to realize what had long seemed a futuristic dream—using computer-controlled robots to perform operations. Beginning in 1995 Seattle surgeon Frederic Moll, with the help of an electrical engineer named Robert Younge, developed one of the first robotic surgeon prototypes—a combination of sensors, actuators, and microprocessors that translated a surgeon's hand movements into more fine-tuned actions of robotic arms holding microinstruments. Since then other robotics-minded physicians and inventors have created machines that automate practically every step of such procedures as closed-chest heart surgery, with minimal human involvement. The list of health care technologies that have benefited from engineering insights and accomplishments continues to grow. Indeed, at the end of the century bioengineering seemed poised to be fully integrated into biological and medical research. It seemed possible that advances in understanding the genetic underpinnings of life might ultimately lead to cures for huge numbers of diseases and inherited ills—either by reengineering the human body's own cells or genetically disabling invading organisms. Certainly engineering techniques—particularly computerized analyses—had already helped identify the complexities of the code. The next step, intervening by replacing or correcting or otherwise manipulating genes and their components, seemed in the offing. Although the promise has so far remained unfulfilled, engineering solutions will continue to play a vital role in many of medicine's next great achievements.
1903 First electrocardiograph machine Dutch physician and physiologist Willem Einthoven develops the first electrocardiograph machine, a simple, thin, lightweight quartz "string" galvanometer, suspended in a magnetic field and capable of measuring small changes in electrical potential as the heart contracts and relaxes. After attaching electrodes to both arms and the left leg of his patient, Einthoven is able to record the heart’s wave patterns as the string deflects, obstructing a beam of light whose shadow is then recorded on a photographic plate or paper. In 1924 Einthoven is awarded the Nobel Prize in medicine for his discovery. 1903 First electrocardiograph machine Dutch physician and physiologist Willem Einthoven develops the first electrocardiograph machine, a simple, thin, lightweight quartz "string" galvanometer, suspended in a magnetic field and capable of measuring small changes in electrical potential as the heart contracts and relaxes. After attaching electrodes to both arms and the left leg of his patient, Einthoven is able to record the heart’s wave patterns as the string deflects, obstructing a beam of light whose shadow is then recorded on a photographic plate or paper. In 1924 Einthoven is awarded the Nobel Prize in medicine for his discovery.
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