Federico Gheza, MD1, Fadekemi O Oginni, MD2, Adewale O Adisa, MD2, Mario A Masrur, MD1. 1UIC, 2Faculty of Clinical Sciences, Obafemi Awolowo UniversityIle-Ife, Osun State, NIGERIA
Introduction: Minimally invasive surgical techniques (MISTs) could have tremendous applications and benefits in resource poor environment. These include but are not limited to short hospital stay, reduced cost of care, and reduced morbidity, especially related to post operative infections. There is growing interest in MISTs in most low and middle income countries (LMIC) but its adoption has remained limited largely due to high cost of initial set-up, lack of technological backup and limited access to training among others. One of the most limiting factors is the maintenance of the vision system. An affordable laparoscopic set-up as an example will therefore go a long way in improving access to MISTs.
Methods and Procedures: a common zero-degrees 10 mm scope is attached on the camera of a low price smartphone (Samsung Galaxy J3 2016, Samsung®, Seoul, South Korea). Two elastic bands are used to fix the scope right in front of the main camera on the smartphone. The device is covered with sterile transparent drapes (Tegaderm®, 3M Corporate, St. Paul, MN, USA). A light source is connected with a fiber optic cable for endoscopic use. The image can be seen in real time on a common TV screen through an HDMI connection to the smartphone, with a sterile drape. Holding the vision system through the scope would guarantee to keep the camera in place without issues. To operate in full screen the vision was digitally zoomed at 1.6X, without losing quality (that is more related to the intensity of the light). As a collateral project we built a low cost simulator training box with the same camera to train the surgeon, obtaining a high fidelity and affordable simulation setting.
Results: we were able to perform the 5 tasks of the Fundamentals of Laparoscopic Surgery curriculum using our vision system with proficiency. In a pig model, we performed a tubal ligation to simulate an appendectomy and we were able to perform basic laparoscopic suturing. No major issue were encountered and small adjustment only were required to have an acceptable, stable and clear view.
Conclusion: There is growing interest in minimally invasive surgeries among surgeons in LMIC, but its adoption has remained limited due to reasons such as high cost of initial set-up, lack of technological backup and limited access to training among others. An affordable laparoscopic camera system will therefore go a long way in improving access to MIS in such settings
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88539
Program Number: P475
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster