SignificanceLaparoscopy has become the standard of care for surgery in the chest and abdomen but is typically unavailable in low- and middle-income countries (LMICs). This inaccessibility is partly due to a high initial equipment purchase price, ongoing maintenance costs, unreliable electricity, shortage of biomedical technicians, and limited sterilization facilities.AimTo address these challenges, a low-cost, durable, reusable laparoscopic system (KeyScope) was designed for use in LMICs.ApproachThrough an iterative human-centered design approach, the performance of the KeyScope was optimized by comparing standard image quality metrics to a commercially available standard-of-care (SOC) laparoscope.ResultsThe latest version of the KeyScope has comparable or better resolving power, lens distortion, field of view, depth of field, and color reproduction accuracy to a SOC laparoscope (Precision Ideal Eyes HD Laparoscope, Stryker) at working distances commonly used during laparoscopic surgery (3 to 13 cm). Interference from electrocautery was eliminated by shielding the camera ground from the housing ground. Finally, the entire KeyScope is equipped for production and implementation in sub-Saharan Africa, as the device can be submerged in Cidex and can be easily assembled in Uganda in under 1 h.ConclusionThese results suggest that the KeyScope has achieved the performance criteria needed for surgical care in LMICs.
SignificanceLaparoscopic surgery is generally unavailable in low- and middle-income countries (LMICs) due to the high cost of installation and lack of qualified personnel to maintain and repair equipment. We developed a low-cost, durable, reusable laparoscopic system, called the KeyScope laparoscope, for use in LMICs. To reliably build and service the KeyScope in LMICs, a portable testing chamber (PTC) is needed to assess image performance.AimA PTC was developed to characterize KeyScope laparoscope performance in LMICs.ApproachImages of standard resolution, color accuracy, distortion, and depth of field (DOF) targets were captured in both a standard optical bench setup (OBS) and the PTC. Measurements from the OBS and PTC were quantified and compared using standard software (ImageJ and Imatest). To further reduce cost, alternative paper imaging targets were identified and compared with standard glass targets. To improve usability, MATLAB applications (apps) were developed to automate image analysis and reduce cost.ResultsThe PTC achieved similar results compared to the OBS for the image quality metrics, distortion and DOF. Further, the PTC presented similar results to the OBS for resolution at 4 to 7 cm working distances and improved resolution at periphery working distances of 3 and 10 cm. Color accuracy values were also improved in the PTC compared with those measured in the OBS. The low-cost resolution, color accuracy, and distortion targets resulted in similar image quality results to the standard image quality target. MATLAB apps produced similar results to Imatest and ImageJ software and decreased the time to complete image quality test analysis.ConclusionThe low-cost portable design of the PTC will facilitate the translation of the KeyScope by enabling accurate and fast characterization of laparoscopic imaging performance in LMICs.
Access to the requested content is limited to institutions that have purchased or subscribe to SPIE eBooks.
You are receiving this notice because your organization may not have SPIE eBooks access.*
*Shibboleth/Open Athens users─please
sign in
to access your institution's subscriptions.
To obtain this item, you may purchase the complete book in print or electronic format on
SPIE.org.
INSTITUTIONAL Select your institution to access the SPIE Digital Library.
PERSONAL Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.