Peritoneoscopy

Though the fact is not generally known, the contents of the abdomen can be examined without a major "exploratory" operation, which is usually dangerous, occasionally fatal. Yet this simple method, called peritoneoscopy. was developed 37 years ago by Dr. Georg Kelling of Dresden, was neatly perfected four years ago by Dr. John Carroll Ruddock of Los Angeles. Last fortnight the New England Journal of Medicine printed an article on this useful subject, by Boston's Dr. Edward Benson Benedict, whose experience confirmed Dr. Ruddock's--that with a peritoneoscope he can make an accurate diagnosis of ailments within the abdomen in almost every case, whereas clinical diagnosis scores only 64%. However, peritoneoscopists will not risk prying into an inflamed abdomen.

The Method is simplicity itself: insertion of a big hollow needle through a quarter-inch puncture into the cavity of the abdomen. The mobility of the liver, stomach, intestines, bladder, ovaries and womb is such that Dr. Ruddock can poke them around by means of a slender telescope inserted through the hollow needle. He can inspect them by the aid of electric lights placed at the tip of the telescope. swallowed into the stomach, or received into the colon. By means of special nippers he can snip out a piece of suspect tissue from an internal organ, immediately seal the wound with an electric current. After inspection, Dr. Ruddock closes the hole in the abdomen with a single stitch. Others simply use adhesive tape.

The Views. Dr. Ruddock warns spyers into the abdomen that "the whole examination should be done with a fixed plan in mind, otherwise the wonderful natural pictures would tend to lead astray and thus prevent seeing the important points."

Some of those views: "The surface of small coiled intestines . . . normally . . . appear with a slightly brownish hue, and peristaltic [movement] waves can be noted. ... A small liver with a wrinkled surface and hobnailed irregularities would suggest cirrhosis. Adhesions . . . may be spider web, lacelike, or massive bands. ... When the stomach wall is transilluminated, the stomach appears to observers like a Chinese lantern."

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