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Maksimoski M, Maurrasse SE, Valika T. A Quantitative Analysis of Smartphone-Based Endoscopy and Video Tower Endoscopy. Ann Otol Rhinol Laryngol 2023; 132:1418-1423. [PMID: 36999527 DOI: 10.1177/00034894231162678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
OBJECTIVES Examine the differences between traditional tower-based endoscopy (TBE) and smartphone-based endoscopy (SBE) using objective measures of cost, setup time, and image quality. METHODS Cost analysis study and randomized single-blinded prospective trial was performed at a tertiary academic health center. Twenty-three healthcare providers, 2 PA-C, 9 residents, 2 fellows, 10 attendings varying in practice from 1 to 27 years were a part of the study. Actual cost analysis was used for purchase of the Karl Storz video tower system and the Save My Scope smartphone-based endoscopy system for cost analysis. For setup time, providers entered a room and were randomized to set up either an SBE or TBE system and timed from room entry to a visible on-screen image. A crossover was then performed so all providers performed both setups. For image discernment, standardized photos of a modified Snellen's test were sent via text message to providers who were blinded as to which photo represented which system. Practitioners were randomized as to which photo to receive first. RESULTS Cost savings was 95.8% ($39,917 USD) per system. Setup time for the smartphone system was 46.7 seconds less than video tower system on average (61.5 vs 23.5 seconds; P < .001, 95% CI: 30.3-63.1 seconds). Level of visual discernment was slightly better for SBE over TBE, with reviewers able to identify Snellen test letters at a size of 4.2 mm with SBE versus 5.9 mm with TBE (P < .001). CONCLUSIONS Smartphone-based endoscopy was found to be cheaper, quicker to set up, and to have marginally better image quality when transmitted via messaging than tower-based endoscopy, although the clinical significance of these visual differences are unknown. If appropriate for their needs, clinicians should consider smartphone-based endoscopy as a viable option for viewing and collaborating on endoscopic images from a fiberoptic endoscope.
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Affiliation(s)
- Matthew Maksimoski
- Department of Otolaryngology - Head and Neck Surgery, Northwestern University, Chicago, IL, USA
- Division of Pediatric Otolaryngology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Sarah E Maurrasse
- Division of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
- Division of Pediatric Otolaryngology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Taher Valika
- Department of Otolaryngology - Head and Neck Surgery, Northwestern University, Chicago, IL, USA
- Division of Pediatric Otolaryngology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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Chatzipapas IK, Kathopoulis NI, Siemou PT, Protopapas AK. Wireless Cystoscope the Future of Cystoscopy (With Video). Surg Innov 2023; 30:628-631. [PMID: 36450157 DOI: 10.1177/15533506221143268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Background: The first modern cystoscope was developed with the invention of rod lens and optical fibers in the 1960s. Since then, many advances have been made in functionality and camera image analysis. The cost of purchasing equipment and volume of the endoscopic tower remains a challenge and a barrier to the spread of cystoscopy. Urinary tract injury is a significant complication in women undergoing gynecologic surgery. Selective intraoperative cystoscopy at laparoscopic hysterectomy or complex pelvic surgery is valuable for recognizing lower urinary tract injuries. We have developed a novel wireless cystoscope for performing diagnostic and operative cystoscopy. Methods: The new wireless cystoscopic setup consists of a rigid cystoscope 4 mm, 30° that joins a modified action camera to a c-mount adapter f 18-35 mm and a portable led light source. Results: The new setup has so far been effectively used in more than 50 diagnostic cystoscopies and pigtail catheter replacements without complications. Two cases performed with the new setup are presented in the video. Conclusions: The new cystoscopic setup has the advantage of a wireless video camera, 4K ultraHD, and is easy setup. Due to its low cost and portability, the wireless cystoscope is easy to obtain and use. Also, it is invaluable and ergonomic in managing the integrity or pathology of the bladder, urethra, and ureters.
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Affiliation(s)
- Ioannis K Chatzipapas
- 1st Department of Obstetrics and Gynecology, University of Athens, Alexandra hospital, Athens, Greece
| | - Nikolaos I Kathopoulis
- 1st Department of Obstetrics and Gynecology, University of Athens, Alexandra hospital, Athens, Greece
| | | | - Athanasios K Protopapas
- 1st Department of Obstetrics and Gynecology, University of Athens, Alexandra hospital, Athens, Greece
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A new era: Comparing wired to wireless endoscopy. Curr Urol 2023. [DOI: 10.1097/cu9.0000000000000176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Kholafazad-Kordasht H, Hasanzadeh M, Seidi F. Smartphone based immunosensors as next generation of healthcare tools: Technical and analytical overview towards improvement of personalized medicine. Trends Analyt Chem 2021. [DOI: 10.1016/j.trac.2021.116455] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Mobile Hysteroscopy With the Use of a Smartphone as a Cost-Effective, Diagnostic Technique. Obstet Gynecol 2021; 138:795-798. [PMID: 34619738 DOI: 10.1097/aog.0000000000004549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 07/19/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Smartphone technology can be adapted to promote cable-free, wireless, and cost-effective diagnostic mobile office hysteroscopy. INSTRUMENT We developed a new cable-free setup by coupling a rigid 30°, 2-mm-diameter hysteroscope to a smartphone using a commercially available adapter and using a portable and rechargeable light-emitting diode cold light source. The new setup cost is considerably lower compared with that of a typical endoscopic tower. EXPERIENCE We performed both standard hysteroscopy and hysteroscopy using the new portable setup in 40 patients for a variety of benign gynecologic indications. The operating time was compared between the two methods, as was the pain perceived by the patients. Videos from the two setups were blindly reviewed and scored by experts regarding image resolution, brightness, color, and overall image quality. The new technique was acceptable for diagnosis in 97.5% of the videos. CONCLUSION We report a promising initial experience using a smartphone to provide a convenient, cable-free, low-cost, office hysteroscopy system.
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Abstract
BACKGROUND Wireless signal transduction is the future in the field of laparoscopic surgery. Cable-free endoscopic equipment would be the ideal surgical instrument for every laparoscopic surgeon. INSTRUMENT Our department has developed a new cable-free laparoscopic setup that couples a rigid 0°, 10-mm laparoscope with a wireless camera modified with a special adapter. We used a portable and rechargeable LED cold light source. The signal was wirelessly transmitted from the camera to a tablet computer using the corresponding mobile application. EXPERIENCE Our team has used this setup in 14 laparoscopic operations with excellent results. Two cases performed exclusively with the new setup are presented in the videos. The image quality obtained was comparable with the conventional laparoscopic setup, and the operations performed were unaffected. CONCLUSION This report presents the use of a wireless camera throughout the course of a laparoscopic surgery, and the results are promising. The new systems' favorable characteristics, such as wireless signal transmission, cost, flexibility, and size, support this as a feasible new technique for performing laparoscopic surgery.
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Kumar H, Tanveer N, Dixit S, Diwan H, Naz F. Smartphone-assisted tele-gynepathology: A pilot study. J Obstet Gynaecol Res 2020; 46:1879-1884. [PMID: 32875651 DOI: 10.1111/jog.14347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/09/2020] [Accepted: 05/23/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Traditional telepathology techniques like whole slide imaging require expensive equipment and are currently out of reach of the developing countries. However, the improvements in smartphone camera resolution and availability of faster internet have made smartphone-assisted telepathology possible. METHODS A total of 186 cases pertaining to gynecologic pathology reported by single consultant (NT) were retrieved from the records of the histopathology department. A trained histopathologist then photographed representative areas of each case by using the smartphone camera. After a wash off period of 6 months, the images along with the clinical details were sent by Whatsapp Messenger to the same reporting pathologist. The reporting pathologist replied with the diagnosis of each case by using Whatsapp. RESULTS The smartphone diagnosis was concordant in 179/186 (96.2%) cases. The intraobserver concordance rates varied with the organ involved - it was highest for endometrial and myometrial pathology (123/126, 97.6%) lowest for ovarian lesions (08/10, 80%). For cervical pathology, it was 97.2% (35/36) and for fallopian tube pathology it was 92.9% (13/14). CONCLUSION Although the initial results of this pilot study are encouraging, there is a long way to go before smartphone-assisted telepathology can be put to routine use for the second opinion. More experience of the pathologists with this technique and faster internet and better smartphone cameras will further improve the concordance of smartphone-assisted telepathology diagnosis with conventional microscopy diagnosis.
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Affiliation(s)
- Harresh Kumar
- Department of Pathology, University College of Medical Sciences, Dilshad Garden, Delhi, India
| | - Nadeem Tanveer
- Department of Pathology, University College of Medical Sciences, Dilshad Garden, Delhi, India
| | - Sonali Dixit
- Department of Pathology, University College of Medical Sciences, Dilshad Garden, Delhi, India
| | - Himanshi Diwan
- Department of Pathology, University College of Medical Sciences, Dilshad Garden, Delhi, India
| | - Farhat Naz
- Department of Laboratory Oncology, All India Institute of Medical Sciences, Delhi, India
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Harvey L, Curlin H, Grimm B, Lovett B, Ulysse JC, Sizemore C. Experience with a novel laparoscopic gynecologic curriculum in Haiti: lessons in implementation. Surg Endosc 2020; 34:2035-2039. [PMID: 31332562 DOI: 10.1007/s00464-019-06983-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 07/12/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND An estimated one-third of the world's burden of disease requires surgical treatment. In many high-income nations, a large proportion of critical surgical procedures are performed laparoscopically due to a number of advantages the technique offers. There is forward progress in the global surgery field to increase access to laparoscopic techniques in low and middle-income settings (LMIC), with potential benefits to both patients and surgeons. METHODS A week long laparoscopic surgery curriculum for surgeons and hospital staff was designed and implemented in a low-resource setting. An iterative design was used to adapt the curriculum on the ground. RESULTS The local laparoscopic team was able to independently perform two laparoscopic procedures since the course was administered. CONCLUSIONS Implementing laparoscopic surgery programs may be feasible in many LMIC settings. Access to this care may benefit patients. Lessons learned for the global laparoscopist are described.
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Affiliation(s)
- Lara Harvey
- Division of Minimally Invasive Gynecology, Department of Obstetrics & Gynecology, Vanderbilt University Medical Center, 1161 21st Ave South, B-1100 Medical Center North, Nashville, TN, 37232-2521, USA.
| | - Howard Curlin
- Division of Minimally Invasive Gynecology, Department of Obstetrics & Gynecology, Vanderbilt University Medical Center, 1161 21st Ave South, B-1100 Medical Center North, Nashville, TN, 37232-2521, USA
| | - Barry Grimm
- Global Health Section, Department of Obstetrics & Gynecology, Vanderbilt University Medical Center, Nashville, USA
| | - Barbie Lovett
- Perioperative Services, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jean-Claude Ulysse
- Department of Obstetrics & Gynecology, Hôpital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Christopher Sizemore
- Global Health Section, Department of Obstetrics & Gynecology, Vanderbilt University Medical Center, Nashville, USA
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Oosting RM, Wauben LSGL, Madete JK, Groen RS, Dankelman J. Availability, procurement, training, usage, maintenance and complications of electrosurgical units and laparoscopic equipment in 12 African countries. BJS Open 2020; 4:326-331. [PMID: 31984671 PMCID: PMC7092388 DOI: 10.1002/bjs5.50255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 12/02/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Strategies are needed to increase the availability of surgical equipment in low- and middle-income countries (LMICs). This study was undertaken to explore the current availability, procurement, training, usage, maintenance and complications encountered during use of electrosurgical units (ESUs) and laparoscopic equipment. METHODS A survey was conducted among surgeons attending the annual meeting of the College of Surgeons of East, Central and Southern Africa (COSECSA) in December 2017 and the annual meeting of the Surgical Society of Kenya (SSK) in March 2018. Biomedical equipment technicians (BMETs) were surveyed and maintenance records collected in Kenya between February and March 2018. RESULTS Among 80 participants, there were 59 surgeons from 12 African countries and 21 BMETs from Kenya. Thirty-six maintenance records were collected. ESUs were available for all COSECSA and SSK surgeons, but only 49 per cent (29 of 59) had access to working laparoscopic equipment. Reuse of disposable ESU accessories and difficulties obtaining carbon dioxide were identified. More than three-quarters of surgeons (79 per cent) indicated that maintenance of ESUs was available, but only 59 per cent (16 of 27) confirmed maintenance of laparoscopic equipment at their centre. CONCLUSION Despite the availability of surgical equipment, significant gaps in access to maintenance were apparent in these LMICs, limiting implementation of open and laparoscopic surgery.
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Affiliation(s)
- R M Oosting
- Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands
| | - L S G L Wauben
- Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands.,Innovations in Care Research Centre, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - J K Madete
- Department of Electrical and Electronic Engineering, School of Engineering and Technology, Kenyatta University, Nairobi, Kenya
| | - R S Groen
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA
| | - J Dankelman
- Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands
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