William Wolff; advanced colonoscopy field
NEW YORK - Dr. William I. Wolff, who with a colleague revolutionized the diagnosis and treatment of colon cancer by developing the colonoscopy as the procedure is practiced today, died Aug. 20 at his home in Manhattan. He was 94.
His family announced the death.
Working with Dr. Hiromi Shinya at Beth Israel Medical Center in Manhattan in the 1960s, Dr. Wolff was at the forefront of a worldwide research effort to develop ways to probe the full length of the colon using a tube with electronic sensors. Their most significant advance was the development of a device that could remove a polyp immediately during a colonoscopy, eliminating the need for a second procedure.
Their protocol - using one doctor for the procedure instead of two, for example - became the universal standard, and articles they published about their thousands of successes confirmed the safety and efficacy of colonoscopies.
Though often dreaded by patients as much as a root canal, the procedure, if done in time, can eliminate more than 60 percent of large-intestine growths. In the United States, more than 1.6 million colonoscopies are performed each year, mostly as a preventive procedure for adults beginning in middle age. More than 50,000 Americans die from cancer of the colon and rectum each year, making it the second-deadliest cancer.
The colonoscope, the snakelike instrument used in the procedure, solved a longstanding problem: It could negotiate the sharp first turn of the large intestine. That allowed it to examine the full 5 feet of the organ, its fibers lighting the colon’s walls and carrying the reflected image back to the other end of the colonoscope, where it could be viewed by a doctor. Previous procedures could penetrate only about 10 inches before being blocked.
Dr. Wolff and Shinya, working with the
Dr. Francis Moore, a leading surgeon, called this “a quantum advance in abdominal surgery.’’
Dr. Wolff and Shinya first described their surgical procedure in The New England Journal of Medicine; in 1999 the journal Seminars in Colon & Rectal Surgery called it one of the 20th century’s dozen landmark articles in the field.
Colonoscopy expanded through the 1970s and gained wide public exposure when the process was used several times to remove polyps from President Reagan in the mid-1980s. Many news articles mentioned Dr. Wolff and Shinya as the pioneers.
The colonoscope prompted a radical shift in thinking. Earlier, most doctors believed that bowel polyps rarely, if ever, turned into cancer. Today’s prevailing belief is that most, if not all, cancers of the colon arise from polyps.
The colonoscope is an endoscope, as instruments used to examine the body’s interior are known. Endoscopes were being used increasingly in the 1960s to probe downward from the mouth or nose. Dr. Wolff was already doing this as head of surgery at Beth Israel.
They held back from publishing until they had done a minimum of 100 successful procedures. Dr. Wolff’s subsequent articles, all in top journals, “preempted’’ the field, Irvin M. Modlin wrote in his 2000 book, “A Brief History of Endoscopy.’’
William Irwin Wolff was born in Manhattan.