The small intestine is so narrow, long, winding and remote from either mouth or anal that the insertion of a fiberscope into the small intestine is very difficult. We are now trying three kinds of endoscopic insertion methods i. e., push, sonde and ropeway of which my original ropeway method is the only way to get a chance to survey all along the small intestine.
Although the small intestinal fiberscopy has already been one of the useful examinations for practical clinics, it has been not yet a routine examination because of technical difficulties for insertion. Therefore, the indications for the fiberscopy include the cases showing small intestinal trias, that is, colic from an unknown cause, bleedings from the digestive tract (melena) from an unknown cause and malabsorption.
And now, the study of the pathophysiology of the small intestine laying stress on digestion and absorption can't be made complete without the fiberscopy.
The morphological and functional study on the small intestine has been proceeding by an analysis of many biopsy specimens taken by the fiberscopy, and by the morphological analysis of villi by the endoscopic close-up method developed recently. The mobility of villi which are important to digestion and absorption has been successfuly recorded on 16mm movie film. And then, the loading endoscopy which uses dye or fat has been put to practical use.
Thus, much is expected of the small intestinal fiberscopy in the clinical diagnosis.