2012 INNOVATIONS IN UROLOGY

Innovative Portable Video Recording System for Endourologic Surgery

Rogelio F Varela Jr. MD, Jaime C Balingit MD FPUA Department 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 80s. 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. (Fig.1)

Its actual dimension is 40(W)*40(H)*57(D) mm

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 aluminum with 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 Gastroenterology HNS-ENT General Surgery Urology Obstetrics and Gynecology Orthopedics
Conclusion and Recommendation

PROCEDURE Colonoscopy Esophagogastroduodenoscopy (EGD) Otoscopy Laryngoscopy Laparoscopic Surgery Proctoscopy Laparoscopic Surgery Cystoscopy Laparoscopic Surgery Hysteroscopy Arthroscopy

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/surgerysecurity-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 A Tables

Table 1: Specifications of the Camera Head

Lamp Type Color Temperature Power supply Lamp Life Light Intensity On/Off Switch Control Air Pressure Input Voltage Range Dimensions Weight Material and finish

Other features

Cree XP-G LED (R2) 1000 K @ any intensity setting (0-100%) 1.5V AAA (Ni-MH, Alkaline) batteries lifespan of 50,000 hours 190 Lumens Tail cap switch None 3.0V 105mm (Lenght) x 21.5mm (Diameter) 51 gms (excluding battery) Aircraft-grade aluminium Premium Type III hard-anodized anti-abrasive finish Toughened ultra-clear glass lens with anti-reflective coating Waterproof to IPX-8 standard 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 market Olympus Karl Storz System System Php 1.6 M Php 1.6 M 26 Monitor Php 60,000.00 to Php 60,000.00 to Computer Php 90,000.00 Php 100,000.00 Recording System > Php 2.5 M Camera Head Php 2.0 to 2.5 M and Camera Control Unit
*Prices based on inquiries from particular company agents

Aesculap System
Php 1.6 M Php 50,000.00

My system

Php 50,000.00 Php 1.8 to 2.5 M

Appendix B Images 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 9inch 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 Fig. 7 The system also includes two hard casing. (2) remote control one for the monitor and another for the recording system.