Presentation Authors: Sherry Lu*, Renai Yoon, Zhamshid Okhunov, Courtney Cottone, Shlomi Tapiero, Roshan Patel, Jaime Landman, Ralph Clayman, Orange, CA
Introduction: The Endockscope (ES) combines a smartphone, lens system, and a rechargeable LED light source to provide a low-cost alternative ($45) to the standard camera and high-powered light source ($45,000) used in endoscopic procedures. Originally designed for flexible fiberoptic endoscopy, we evaluated the ES performance compared to the standard high power light source and camera viewing system using a broad range of rigid/semi-rigid endoscopes in a fresh-tissue cadaver model.
Methods: Videos of rigid nephroscopy, semi-rigid ureteroscopy, rigid cystoscopy, and laparoscopy in an adult male cadaver were recorded using the ES combined with either the Apple iPhone X (iPX) or Samsung Galaxy S9+ (GS9+), the top performers from our earlier favorable fiberoptic endoscopic study, and then with the standard high-definition (HD) camera system (Karl Storz) and high-powered light source. A total of 14 urologists (10 attendings and 4 residents) blinded to the recording specifics, assessed the image resolution, brightness, color, sharpness, and overall image quality on a 1-5 Likert scale (1 = poor, 5 = excellent); they also judged whether each video was acceptable for diagnostic purposes (yes or no).
Results: Image parameters: For rigid cystoscopy, all image parameters with the ES plus the iPX or the GS9+ were equivalent to the standard system. For rigid nephroscopy, the ES plus the GS9+ or the iPX was inferior in various parameters to the standard system while doing better or equal to the standard system for semi-rigid ureteroscopy. For laparoscopy, the ES plus the GS9+ performed nearly as well as the standard system in all areas except brightness (p < 0.05). In contrast, the ES plus iPX for laparoscopy was uniformly inferior for all image parameters compared to the standard system. Diagnostic assessment: For diagnostic purposes, the ES plus GS9+ was equally acceptable to the standard system for all four endoscopes; the ES plus iPX fell short for both laparoscopic and semi-rigid ureteroscopic diagnostic assessment.
Conclusions: Although the Endockscope system plus the Samsung Galaxy S9+ does not provide an image quality equal to the more costly high powered light source and camera system, the images provided are similarly sufficient for diagnostic assessment to the standard system for rigid endoscopy of the kidney, ureter, bladder and abdomen.