Bladder Stone – 3

Abstract

Cutting for a bladder stone through the perineum or the abdomen, or crushing it blindly and washing out the fragments is okay, but how about looking inside the bladder and dealing with the stone within it under vision? That must have been a curious challenge for our ancestral thinkers and when curiosity and necessity converge the end product is innovation. As Albert Einstein said, “I am neither especially clever nor gifted, I am only curious.”

To look inside you needed a tubular instrument – that could be introduced through the urethra, and light to provide illumination that would allow the examiner to inspect the inside of the bladder and deal with the problem. Easier said than done, but in 1806 Philip Bozinni was the first to use a beeswax candle as the source of light on a tubular instrument to visualize the internal organs.⁽¹⁾ He called it the ‘Lichtleiter’ (light conductor). It was made of silver and was protected with shark skin. Apparently, a specimen is present in the museum of the College of Surgeons in Chicago⁽²⁾ .   His work was reviewed by the medical faculty of Vienna but he was punished for ‘undue curiosity,’ and therefore he could not use it on humans.  However, the French surgeon Antoine Jean Desormeaux (1853) considered to be the ‘Father of Endoscopy’⁽³⁾ was the first to introduce the 'Lichtleiter’ of Bozzini into a patient. His instrument had a system of mirrors and a lens, with a lamp-flame of alcohol and turpentine in a reservoir as the light source. Burns was however, a major issue with his innovation.