Category: Endoscopic

MP21-13 - Combining the Endockscope With Next Generation Smartphones: “A Global Opportunity”

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective :

The Endockscope combines a smartphone, a flashlight, and a fiberoptic cystoscope for mobile videocystoscopy. We compared conventional videocystoscopy to the Endockscope paired with next generation smartphones in a porcine bladder.

Methods :

The Endockscope consists of a three-dimensional printed attachment that connects a smartphone to a fiberoptic cystoscope plus a 1000 lumen light-emitting diode (LED) cordless light (Figure 1).  Video recordings of porcine cystoscopy with a flexible fiberoptic cystoscope (Storz) were captured for the Endockscope paired with 5 mobile devices (Apple iPhone 6, iPhone 6S, iPhone 7, Samsung Galaxy S8, and Google Pixel 1) and for the Storz high-definition H3-Z camera (HD) with a xenon light (XL). Eleven faculty urologists, blinded to the modality used, evaluated each video for image quality/resolution, brightness, color quality, sharpness, overall quality, and acceptability for diagnostic use.

Results :

In each category the HD camera with XL outperformed the smartphone; however, many of the differences were not statistically significant among our sampling of 11 reviewers. When comparing the Endockscope coupled to an iPhone 7 to the HD camera with XL, there were no statistically significant differences in any metric (Table 1); 82% of evaluators considered the iPhone 7 + LED light source appropriate for diagnostic use as compared to 100% with the HD camera with XL. All evaluators (100%) considered the Samsung S8 + LED light appropriate for diagnostic use despite its being rated inferior (p < 0.05) to the HD camera with XL in color quality and overall quality. The iPhone 6S underperformed compared to the HD camera with XL in all metrics except color quality, whereas the iPhone 6 and Pixel 1 were inferior to the HD camera with XL in every measure (p < 0.05).

Conclusions :

The Endockscope system with a LED light when coupled with an iPhone 7 or Galaxy S8 is comparable to conventional fiberoptic videocystoscopy with an HD camera and xenon light.

Roshan M. Patel

Assistant Clinical Professor
University of California, Irvine, Department of Urology
Orange, California

Renai Yoon

University of California, Irvine
Orange, California

Zhamshid Okhunov

University of California, Irvine, Department of Urology
Orange, California

Christina Tse

University of California, Irvine
Orange, California

Ralph V. Clayman

University of California, Irvine, Department of Urology
Orange, California

Jaime Landman

Professor and Chair
Department of Urology, University of California, Irvine, Orange, CA
Orange, California

Professor Landman completed his medical training at Columbia University. He then completed his Urology residency at Mt. Sinai Hospital in New York before moving to St. Louis to complete his minimally invasive urology training at Washington University under the guidance of Dr. Ralph Clayman. Dr. Landman’s fellowship training focused on the minimally invasive treatment of renal diseases.

Prof. Landman focuses on developing new clinical approaches to minimally invasive and more effective treatments for surgical renal diseases such as renal cell carcinoma, urolithiasis and ureteropelvic junction obstruction. For the past decade, his clinical practice has been focused almost exclusively on the minimally invasive management of kidney disease with a focus on renal oncology and urolithiasis.

Since 2002 Dr. Landman has directed an active minimally invasive urology laboratory. His laboratory has focused largely on innovative minimally invasive solutions in the diagnosis and treatment of urologic malignancies, kidney stones and the development of minimally invasive surgical technologies.

A major focus of Dr. Landman’s efforts has been the didactic and technical training of students, residents and fellows. Dr. Landman has had an active role in medical student and resident education since 2001. Since 2002 Dr. Landman has been actively directing the Endourology sanctioned clinical and research fellowship, and he was until recently the program director for the UC Irvine Urology residency. Dr. Landman engendered and currently directs the LIFT (Leadership Innovation Fellowship Training) program at UC Irvine and has focused on helping medical students become academic leaders in Urology.

A current focus of Dr. Landman’s research remains didactic and technical training for students, residents and fellows. His research team continues to develop novel strategies for surgical education.