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R. JOHN C. SPIVEY JR. was a third-year medical student at the University of Virginia when a physician came to the school to demonstrate a new way of inspecting the colon with a flexible scope.
"Everybody said, 'That can't possibly work,'" Spivey recalled.
The technique did work. In fact, it worked better than the technique then being used, the X-ray and barium enema.
Today, 40 years later, the flexible scope, called the endoscope, is an important tool in the arsenal of physicians like Spivey.
Gastroenterologists, pulmonologists and other physicians are doing 8,000 endoscopic examinations a year at Mary Washington Hospital. And now they are doing these tests, for colon cancer and other diseases, in the hospital's new Endoscopy Center.
The center has moved downstairs to the first floor of the hospital in quarters that are four times larger than its former home on the second floor.
Dr. David B. Rice said he can't help but compare the new center with the facilities he had when he did the area's first endoscopy in 1971. He did the procedure in a cramped closet on the first floor at the old Mary Washington Hospital on Fall Hill Avenue.
"There wasn't enough room for the patient to lie with their feet stretched out," Rice recalled.
The new center features six private preparation bays and 14 private recovery rooms, a change from the curtained areas that were in the second-floor center. Six new procedure rooms have replaced the three procedure rooms in the old center. The new center opened Feb. 7.
Each day nearly 30 people visit the center to have their insides checked. Doctors look at the patient's lungs, colon, stomach or intestines. They do these inspections without an incision and with a minimum of anesthesia.
The tool they use, the endoscope, is a black, snakelike tube, about 5 feet long and as wide as a pencil. A doctor inserts the tube into the patient's mouth or anus and steers it slowly through the bends of the inner body.
"The major role of the scope is to diagnose in a nonsurgical way," said Dr. Frank J. DeTrane, a Fredericksburg gastroenterologist.
One end of the endoscope contains a video chip, a light, an opening for air and water, and an opening for special tools, such as forceps or snare to remove polyps. When a doctor uses the endoscope, it is as if he or she has crawled inside the body to take a look around.
Today's scopes are much better than the original ones, Spivey said. The video chip provides a better view than the old scopes. Fewer people are needed to operate the scope, and exams can be accomplished in a fraction of the time they once took.
Pulmonologists use the endoscope to inspect the lungs. Gastroenterologists use it in the upper tract to examine the esophagus, stomach and duodenum, and in the lower tract to inspect the colon.
Their patients may complain of hemorrhoids, acid reflux disease, stomach ulcers, unexplained blood loss or inflammatory bowel disease. With the endoscope, the physician is frequently able to find the cause of the problem and treat it.
About 90 percent of the procedures done in the endoscopy center are colonoscopies, or examinations of the colon.
If the endoscope reveals suspicious polyps or an inflamed area--possible signs of cancer--the doctor can remove the tissue for lab testing.
A colonoscopy takes about two to three hours, though most of that time is spent in preparation and recovery. The procedure itself takes about 30 minutes.
The American Cancer Society recommends regular colonoscopies beginning at age 50. Colon cancer is the third most common cancer in the U.S. and can be successfully treated if detected early.
Spivey, a gastroenterologist, points out that the endoscope can do more than detect and treat a cancerous polyp. He believes the test can actually prevent colon cancer.
"It appears that the vast majority of cancers of the colon start with a benign polyp," Spivey said. "Getting rid of that polyp can then prevent cancer of the colon."
To reach JIM HALL: 540/374-5433 jhall@freelancestar.com
