A four year experience with the adaptation of the flexible fiberoptic endoscope to the intraoperative environment is presented in 30 patients. The technique of intraoperative endoscopy was utilized in a wide variety of difficult gastrointestinal surgical problems to include the location of the site and cause of bleeding of obscure etiology; resolution of intraoperative dilemmas without the necessity of opening abdominal viscera; resection of lesions during operations conducted for other pathological processes; and enhancement of diagnosis at laparotomy. There were no complications from the use of intraoperative endoscopy and the technique was beneficial in 28 of the 30 patients (93.3%). Limiting factors in the full utilization of the endoscope at celiotomy were dense adhesions with a shortened mesentery and massive hemorrhage with blood obscuring the intestinal lumen.
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