Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Nov 14, 2019
Date Accepted: Jun 15, 2020
Cost-effective smartphone-based articulable endoscope systems for developing countries: Feasibility study
ABSTRACT
Background:
Endoscopes are widely used for visualizing the respiratory tract, urinary tract, uterus, and gastrointestinal tracts. Despite high demand, people in underdeveloped and developing countries cannot obtain proper access to endoscopy. Moreover, commercially available endoscopes are mostly non-articulable as well as not actively controlled, limiting their use. Articulating endoscopes are required for some diagnosis procedures, owing to their ability to image wide-areas of internal organs. Furthermore, actively controlled articulating endoscopes are less likely to harm the lumen than rigid endoscopes, because they can avoid contact with endothelial tissues.
Objective:
The study aimed to demonstrate the feasibility and acceptability of smartphone-based wide-field articulable endoscope system for minimally invasive clinical applications in resource-poor countries.
Methods:
A thin articulable endoscope system that can be attached to and actively controlled by a smartphone was designed and constructed. The system consists of a flexible endoscopic probe with a continuum mechanism, four motor modules for articulation, a microprocessor for controlling the motor with a smartphone, and a homebuilt application for streaming, capturing, adjusting images and video, and controlling the motor module with a joystick-like user interface. The smartphone and motor module are connected via an integrated C-type On-The-Go (OTG) Universal Serial Bus (USB) hub.
Results:
We tested the device in several human-organ phantoms to evaluate the usability and utility of the smartphone-based articulating endoscope system. The resolution (960 × 720 pixels) of the device was found to be acceptable for medical diagnosis. The maximum bending angle of 110° was designed. The distance from the base of the articulating module to the tip of the endoscope was 45 mm. The angle of the virtual arc was 40.0°, for a curvature of 0.013. The finest articulation resolution was 8.9°. The articulating module succeeded in imaging all eight octants of a spherical target, as well as all four quadrants of the indices marked in human phantoms.
Conclusions:
The portable wide-field endoscope was successfully controlled using a smartphone, yielding clear images with a resolution of 960 × 720 pixels at realistic focal distances. Actively and precisely controlled articulating movements have resulted in minimally invasive monitoring in narrow space of internal organs with providing a wide-area view. We found our smartphone-based active articulated endoscope to be suitable for point-of-care applications in resource-poor countries.
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