The Use of the Handheld USB Microscope for High Resolution Anoscopy

Jacob Eisdorfer, DO, Suraj Alva, MD, Bertram T Chinn, MD, Theodore E Eisenstat, MD, Nitin Mishra, MD, Gregory C Oliver, Kirsten B Wilkins, MD, Joseph R Notaro, MD

Division of Colon and Rectal Surgery, Department of Surgery, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson University Hospital, New Brunswick, New Jersey

Objective: High Resolution Anoscopy (HRA) is emerging as a central component in the screening for and management of anal intraepithelial neoplasia. Most believe that proper performance of HRA requires some magnification. The level and method of magnification have not been standardized in the literature. However, common methods of magnification such as the colposcope and operating microscope require significant capital investment. Furthermore, these instruments commonly do not have a teaching head thereby making resident education more difficult.
Description of the Technology: The handheld USB microscope is both effective and practical for HRA. The Supereyes TM B003+ Multi-function USB Portable Digital microscope (Shenzhen D&F Co., Ltd, Shenzhen,China) is used attached to a laptop with a 15.4 inch screen. The microscope can be adjusted for magnifications of up to 300 X. We utilize 30 X magnification. The microscope is utilized to capture images of the anal canal and perianal skin in all quadrants. This is repeated after the application of 3% acetic acid, and then again after the application of Lugol’s iodine solution. The images of each quadrant are reviewed and suspicious areas are biopsied. All images are then permanently stored.
Conclusions / Future Directions: In order to make anal screening feasible for more practitioners an effective, practical, and cost-effective method must be developed. The handheld USB microscope can be purchased for less than $50, and can be attached to any computer with a USB port. The learning curve is minimal. Faculty and residents who attempted to use it did so without difficulty. An additional benefit is that, the USB microscope images can be viewed in real time on a computer screen and saved as permanent digital files. Viewing images on the computer screen also facilitates resident education. We are currently conducting a clinical trial, comparing the USB hand held microscope to other methods of magnification.

Session: Poster Presentation

Program Number: ETP049