2012 INNOVATIONS IN UROLOGY

Innovative Portable Video Recording System for Endourologic Surgery

Rogelio F Varela Jr. MD, Jaime C Balingit MD FPUADepartment of Urology, East Avenue Medical Center, Diliman, QC, Philippines

Introduction

There are various surgical equipment that are being manufactured nowadays by

multinational companies designed to be more portable – one that can easily be carried

by the on-the-go modern-day surgeons. Indeed, in this era of nano-technology, the

development of both new and contemporary surgical machineries is fast-paced and

continually evolving.

There are only but few literatures that would describe in full details the very first

use of television in endoscopic surgery. Most literatures would date back its use in the

early 80’s. There information is scarce on the early development of the use of video

recording system in the field of Urology as well.

The recent development of computer chip television camera provided the means

to project a magnified view of the operative field onto a monitor and, at the same time,

freed both the operating surgeon's hands, thereby facilitating performance of complex

laparoscopic procedures. It was a seminal event in the field of laparoscopy.

The Equipment and its Specifications

The Camera Head.

The system includes a TC-6047W CCTV Camera with a 1/3” SONY Color CCD

image sensor. This is compatible with an NTSC/PAL Video signal System. Its Horizontal

Resolution is 600 TVL. It has automatic modes for colored and black and white, with a

minimum illumination of 0.1Lux/F1.2 (low illumination mode). White Balance can be

adjusted manually or automatic. It also has an Auto IRIS with Electronic shutter. It has a

functional switch for Anti-flicker mode. (Table 1)

Its Video output is compatible with any 1.0Vp-p Composite Video Output, 75

Ohm. Operating Environment (optimum temperature requirement) -10oC to 50oC within

85%. Its power requirement is DC12V. It does not consume too much electricity since

its Current Consumption is 200mA. Its actual dimension is 40(W)*40(H)*57(D) mm

(Fig.1)

An endoscopic Camera Coupler is a CCD HD adapter, connecting the front lens

and the camera head of the endoscope. It changes the optical signal from the front lens

into image that the CCD sensor of the camera head can recognize and process.

The coupler used in this system was ordered through online market and is made

up of medical grade steel. It has a 22mm focal length. (Fig.2)

The Monitor

The present prototype carries a 9-inch LCD TV that is compatible with the

camera system. (Fig 3.1, 3.2)

The Recording System

A Verbatim's MediaStation HD DVR is included in the system. It is a multimedia

player and recorder with a DVB-T/analogue hybrid TV tuner, built-in NTFS-formatted

SATA hard drive and wireless networking with a good balance of format support and

connectivity. (Fig.4)

Socketry includes an SD/MS card slot, USB and USB Host, component video

out, an HDMI 1080i out, LAN, coaxial, optical and RF. A remote control, a bundle of

cables and a software disc including Nero MOVE IT software are provided.

An onscreen display offers five main options; TV In, File copy, Setup, Browser

and Timer. Features include recording, storage and playback of TV broadcasts;

upscaling to HD during playback; one-touch and scheduled recording using an EPG;

time-shift recording; image photo back up from the memory card slot; media playback

from the card slots or USB; H.264 playback from PC via the provided Transcode Server

software; and streaming media playback via Ethernet and wireless LAN.

A remote control is also included. It can play back MP3, WMA, WAV7/8, OGG,

AAC, JPEG and BMP; and MPEG-1/2/4, DivX 3/4/5/6 and MP4 AVC (H.264) via the

supplied Transcode Server PC software.

The Lightsource

The author also designed the light source included in this unit, and its prototype

has been previously presented in the 2010 Innovations in Urology at the University of the

East Ramon Magsaysay Memorial Medical Center.

It has a Cree XP-G (R5) LED with a lifespan of 50,000 hours, with a digitally

regulated output - maintains constant brightness. It has a reverse polarity protection, to

protect from improper battery installation. (Table 2) It has an anti-roll, slip-resistant body

design. It also has a tactical tail cap switch with momentary-on function. It is made of

durable aircraft-grade aluminumwith premium Type III hard-anodized anti-abrasive

finish. It has a toughened ultra-clear glass lens with anti-reflective coating. It is powered

by one 3V CR123A battery. It weighs 44-gram weight (excluding battery). Its actual

dimension is 89mm (Length) x 21.5mm (Diameter) (Fig.5)

The Waterproof Casing

The casing is a waterproof, shock proof, environment friendly hard casing with

ergonomic design. It is made up of polypropylene plastic. It is light, weighing only 412g,

with an external dimension of 210 x 167 x 90 mm and internal dimension of 186 x 123 x

75mm. (Fig.6)

Clinical Application

All surgical specialties may benefit from this portable video system since all

specialties are inclined to minimally invasive surgical technique. Listed below are some

of the procedures.

SURGICAL SPECIALTY PROCEDUREGastroenterology Colonoscopy

Esophagogastroduodenoscopy (EGD)HNS-ENT Otoscopy

LaryngoscopyGeneral Surgery Laparoscopic Surgery

ProctoscopyUrology Laparoscopic Surgery

CystoscopyObstetrics and Gynecology Laparoscopic Surgery

HysteroscopyOrthopedics Arthroscopy

Conclusion and Recommendation

This is cost-effective equipment that can be easily transported by any surgeon

anywhere he goes. Comparing it with equipment that is sold by multinational

companies, the price of this unit is way to low (Table 3). It is recommended however to

be used by more surgeons to be able to test its clinical applicability.

References

1 Laparoscopic surgery http://en.wikipedia.org/wiki/Laparoscopic_surgery

2 Close-circuit television http://blogs.smithsonianmag.com/paleofuture/2012/06/surgery-security-and-sales-the-future-of-closed-circuit-television/

3 Verbatim mediastation catalogue http://www.verbatim-europe.com/mediastation/module.htm

4 Varela R, Garcia LA, Bernardo PM, Pocket-sized light source device for endoscopic surgery in urology. Phil J Uro June 2011; 21(1):5-8

5 Waterproof Casing catalogue http://www.cdrking.com/index.php?mod=products&type=view&sid=13299&main=141

6 http://en.wikipedia.org/wiki/Endoscopy

Appendix ATables

Table 1: Specifications of the Camera Head

Lamp Type Cree XP-G LED (R2)Color Temperature 1000 °K @ any intensity setting (0-100%)Power supply 1.5V AAA (Ni-MH, Alkaline) batteriesLamp Life lifespan of 50,000 hoursLight Intensity 190 LumensOn/Off Switch Control Tail cap switchAir Pressure NoneInput Voltage Range 3.0VDimensions 105mm (Lenght) x 21.5mm (Diameter)Weight 51 gms (excluding battery)Material and finish Aircraft-grade aluminium

Premium Type III hard-anodized anti-abrasive finishToughened ultra-clear glass lens with anti-reflective coatingWaterproof to IPX-8 standard

Other features Provides excellent image contrast for viewing and video capture.Constant Color Temperature Delivers accurate color balance.Enhances tissue differentiation.Quiet Operation.

Table 2: Specifications of the light source Varelight

Prices of Common Video system in the marketOlympus System

Karl Storz System

Aesculap System

My system

26” Monitor Php 1.6 M Php 1.6 M Php 1.6 MComputer Recording System

Php 60,000.00 toPhp 90,000.00

Php 60,000.00 toPhp 100,000.00

Php 50,000.00Php

50,000.00Camera Head and Camera Control Unit

Php 2.0 to 2.5 M > Php 2.5 M Php 1.8 to 2.5 M

*Prices based on inquiries from particular company agents

Appendix BImages and Illustrations

Fig. 1 High-grade CCT Camera that was used in the study

Fig. 2 Coupler used for the study

Fig. 3.1 First prototype of the system includes a 21-inch monitor.

Fig. 3.2 Present prototype includes a 9”inch monitor

Fig. 4 Verbatim Mulitmedia Recorder used the study

Fig. 5 Varelyte TM portable light source packaged in the system

Fig. 6 The system is enclosed in a water tight hard casing.

Fig. 7 The system also includes two (2) remote control – one for the monitor and another for the recording system.