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William I. Wolff, Colonoscopy Pioneer

Photograph of Dr. William I. Wolff

Dr. William I. Wolff

Dr. William Wolff died on August 20 at his home Manhattan.  He was 94.

In the mid 1960′s Dr. Wolff, working with his colleague Dr. Hiromi Shinya at Beth Israel Medical Center in New York, began studying how fiber optics and a long, soft, flexible tube might make it possible to see inside the entire length of the colon.  Together they developed  the first colonoscope.

In 1969, Dr. Shinya invented a wire snare and electrocautery making it possible for the team to remove polyps during a colonoscopy.

By 1973, Dr. Wolff and Dr. Shinya had performed over 2,000 colonoscopies in the Endoscopy Unit at Beth Israel, demonstrating that in skilled hands they could be done safely.  Their use of a wire loop snare and electrocautery made it possible to remove most polyps during the colonoscopy itself and avoid risky abdominal surgery.

Last year more than 1.6 million colonoscopies were done in the United States, preventing tens of thousands of future colon cancers.

In February of 1973, Wolff and Shinya, published Polypectomy via the fiberoptic colonoscope. Removal of neoplasms beyond reach of the sigmoidoscope in the New England Journal of Medicine, a key step forward.

Later that year Dr. Wolff and Dr. Shinya wrote a review of 499 polypectomies, A New Approach to Colonic Polyps, in the Annals of Surgery.  The article has been scanned and is available online from the National Library of Medicine.

Before Wolff and Shinya’s work, colon polyps were identified when there was rectal bleeding or, in rare cases, when the colon telescoped in on itself and produced an obstruction.  How to manage the polyp was difficult.  Either abdominal surgery to remove it or repeated barium enemas to observe it produced a lot of uncertainty for the doctor and anxiety for the patient.  Both surgery and radiation posed significant risks.

Colonoscopy and polypectomy allowed most polyps to be removed without surgery and fully examined outside the body by a pathologist for signs of cancer.

In the Annals of Surgery article, Wolff and Shinya concluded in part:

1. The fiberoptic colonoscope renders all parts of the colon endoscopically accessible in most patients.

2. Most polyps of the colon can be removed via the colonoscope once the requisite expertise has been realized.

3. Endoscopic polypectomy can be accomplished with a high degree of safety: 499 polyp removals are reported with no mortality and with only two significant complications.

Though the years colonoscopy has helped identify patients who have colorectal cancer, manage patients with ulcerative colitis and Crohn’s disease, and now — critically important — prevent colorectal cancer by finding and removing polyps before they can ever proceed to cancer.

We at Fight Colorectal Cancer are grateful to William Wolff for what his work has meant in saving many lives, and extend our sympathy to his family.

You can read his obituary in the New York Times.

Photograph of Dr. Wolff appeared in the New York Times.

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