Global Assessments of the Endockscope System: Long-Term Impact of Cyber Endoscopy.

The disproportionate costs of state-of-the-art endoscopic equipment prohibit urologists from performing endoscopy in underserved countries. Given the global prevalence of smartphones, we engineered a $45 alternative endoscope utilizing three-dimensional (3D) printed attachments, an 8x lens, and a 1,000-lumen light-emitting diode (LED) cordless flashlight (Endockscope System (ES)).

At the 34th World Congress of Endourology in Cape Town, South Africa (WCE 2016; 4-year group) and at the 39th Congress of the Société Internationale d'Urologie in Athens, Greece (SIU 2019; 8-month group), a total of 40 ES kits were distributed free of charge to an international group of urologists. Participants were given instructions and a hands-on demonstration of the device. Urologists given an ES were subsequently asked to complete a survey between June and September 2020 which included questions regarding user satisfaction, comfort, and comparability of the ES to standard endoscopic systems.

Urologists from 23 countries received ES kits. Overall, 10 of 22 urologists (10/22; 45%) from the 4-year group and 18 of 18 urologists (18/18; 100%) from the 8-month group completed the survey. The ES device was used by 80% (8/10) and 83% (15/18) of urologists from the 4-year and the 8-month groups, respectively. Of note, the greatest impact of ES usage was among urologists from the most impoverished countries. Of those who used the ES, 44% (4/9) of urologists from the 4-year cohort and 47% (8/17) from the 8-month cohort reported they were able to perform more endoscopic procedures directly because of the ES. Moreover, 57% (4/7) of the 4-year participants and 67% (10/15) of the 8-month participants found the ES equal or superior in quality to their standard endoscopic equipment.

The ES provided an effective and inexpensive system that enabled urologists in resource-challenged countries to successfully perform and expand their use of urological endoscopy.

Journal of endourology. 2021 Apr 30 [Epub ahead of print]

Andrew Shea Afyouni, Mitchell O'Leary, Zhamshid Okhunov, Maged Ayad, Renai Yoon, Andrew Brevik, Akhil Peta, Roshan M Patel, Benjamin Dolan, Jaime Landman, Ralph Clayman

University of California Irvine, 8788, Department of Urology, 333 City Blvd W, Orange, California, United States, 92868; ., University of California Irvine, 8788, Urology, Orange, California, United States; ., University of California Irvine, 8788, Urology, Orange, California, United States., University of California Irvine, 8788, Urology, 101 The City Drive S, Orange, California, United States, 92868; ., University of California Irvine, 8788, Urology, Orange, California, United States; ., University of California Irvine, 8788, Urology, 333 City Blvd West, Orange, California, United States, 92868., University of California Irvine, 8788, Urology, 333 City Blvd, Suite 2170, Orange, California, United States, 92868; ., University of California Irvine, 8788, Urology, Orange, California, United States; ., University of California, Irvine, Engineering, Irvine, California, United States; ., University of California Irvine, 8788, Urology, Orange, California, United States; ., University of California Irvine, 8788, Urology, Orange, California, United States; .

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