The Endockscope Using Next Generation Smartphones: "A Global Opportunity".

Introduction: The Endockscope combines a smartphone, a battery powered flashlight and a fiberoptic cystoscope allowing for mobile videocystoscopy. We compared conventional videocystoscopy with the Endockscope paired with next generation smartphones in an ex-vivo porcine bladder to evaluate its image quality. Materials and Methods: The Endockscope consists of a three-dimensional (3D) printed attachment that connects a smartphone to a flexible fiberoptic cystoscope plus a 1000 lumen light-emitting diode (LED) cordless light source. Video recordings of porcine cystoscopy with a fiberoptic flexible cystoscope (Storz) were captured for each mobile device (iPhone 6, iPhone 6S, iPhone 7, Samsung S8, and Google Pixel) and for the high-definition (HD) H3-Z versatile camera setup with both the LED light source and the xenon light (XL) source. Eleven faculty urologists, blinded to the modality used, evaluated each video for image quality/resolution, brightness, color quality, sharpness, overall quality, and acceptability for diagnostic use. Results: When comparing the Endockscope coupled to a Galaxy S8, iPhone 7, and iPhone 6S with the LED portable light source to the HD camera with XL, there were no statistically significant differences (p<0.01) in any metric. Eighty-two percent and 55% of evaluators considered the iPhone 7 + LED light source and iPhone 6S + LED light, respectively, appropriate for diagnostic purposes as compared with 100% who considered both the HD camera with XL and Galaxy S8 + LED appropriate. The iPhone 6 and Google Pixel coupled with the LED source were both inferior to the HD camera with XL in all metrics. Conclusions: The Endockscope system with a LED light source ($45) when coupled with either an Apple iPhone 7 or Samsung Galaxy S8 is comparable to conventional videocystoscopy with a standard camera and XL light source (total cost: $45,000).