title: Endockscope: using mobile technology to create global point of service endoscopy.
abstract: OBJECTIVE
  Recent advances and the widespread availability of smartphones have ushered in a new wave of innovations in healthcare. We present our initial experience with Endockscope, a new docking system that optimizes the coupling of the iPhone 4S with modern endoscopes.
  
  
  METHODS
  Using the United States Air Force resolution target, we compared the image resolution (line pairs/mm) of a flexible cystoscope coupled to the Endockscope+iPhone to the Storz high definition (HD) camera (H3-Z Versatile). We then used the Munsell ColorChecker chart to compare the color resolution with a 0° laparoscope. Furthermore, 12 expert endoscopists blindly compared and evaluated images from a porcine model using a cystoscope and ureteroscope for both systems. Finally, we also compared the cost (average of two company listed prices) and weight (lb) of the two systems.
  
  
  RESULTS
  Overall, the image resolution allowed by the Endockscope was identical to the traditional HD camera (4.49 vs 4.49 lp/mm). Red (ΔE=9.26 vs 9.69) demonstrated better color resolution for iPhone, but green (ΔE=7.76 vs 10.95), and blue (ΔE=12.35 vs 14.66) revealed better color resolution with the Storz HD camera. Expert reviews of cystoscopic images acquired with the HD camera were superior in image, color, and overall quality (P=0.002, 0.042, and 0.003). In contrast, the ureteroscopic reviews yielded no statistical difference in image, color, and overall (P=1, 0.203, and 0.120) quality. The overall cost of the Endockscope+iPhone was $154 compared with $46,623 for a standard HD system. The weight of the mobile-coupled system was 0.47 lb and 1.01 lb for the Storz HD camera.
  
  
  CONCLUSIONS
  Endockscope demonstrated feasibility of coupling endoscopes to a smartphone. The lighter and inexpensive Endockscope acquired images of the same resolution and acceptable color resolution. When evaluated by expert endoscopists, the quality of the images overall were equivalent for flexible ureteroscopy and somewhat inferior, but still acceptable for flexible cystoscopy.
authors.affiliation: Department of Urology, University of California, Irvine, Orange, California 92862, USA.
authors.forename: William
authors.initials: W
authors.lastname: Sohn
authors.forename: Samir
authors.initials: S
authors.lastname: Shreim
authors.forename: Renai
authors.initials: R
authors.lastname: Yoon
authors.forename: Victor B
authors.initials: VB
authors.lastname: Huynh
authors.forename: Atreya
authors.initials: A
authors.lastname: Dash
authors.forename: Ralph
authors.initials: R
authors.lastname: Clayman
authors.forename: Hak J
authors.initials: HJ
authors.lastname: Lee
mesh_terms: D000818:Animals; D040421:Cell Phone / Q000191:economics; D003116:Color; D020684:Cystoscopes; D003558:Cystoscopy / Q000295:instrumentation; D019723:Endoscopes / Q000191:economics; D004724:Endoscopy / Q000191:economics / Q000295:instrumentation*; D004867:Equipment Design; D005240:Feasibility Studies; D017048:Health Care Costs; D007090:Image Interpretation, Computer-Assisted / Q000295:instrumentation; D020706:Laparoscopes; D010535:Laparoscopy / Q000295:instrumentation; D063731:Mobile Applications; D023421:Models, Animal; D019095:Point-of-Care Systems / Q000191:economics / Q000592:standards; D011237:Predictive Value of Tests; D013552:Swine; D020709:Ureteroscopes; D018666:Ureteroscopy / Q000295:instrumentation; D059015:Wireless Technology / Q000295:instrumentation