Assistant Professor University of Maryland College Park, Maryland, United States
Introduction: Laparoscopic biopsy is a standard of care approach to obtain biopsies of potentially cancerous tissue within the chest and abdomen in high-income countries. It avoids large incisions by using a tiny camera and fine instruments manipulated through keyhole incisions. However, patients in low and middle-income countries (LMICs) have limited access to laparoscopy due in part to shortages in equipment.
Materials and
Methods: To address this unmet need, we are developing a low-cost, reusable laparoscopic system, called the KeyScope. Rather than using fiber optic cables, KeyScope contains light emitting diodes (LEDs) and a color complementary metal-oxide-semiconductor (CMOS) detector that is moved to the front of the device. Through 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.
Results, Conclusions, and Discussions: The latest version of the KeyScope has comparable or better resolving power, lens distortion, field of view, depth of field, and color reproduction accuracy to an SOC laparoscope at working distances commonly used during laparoscopic surgery (3-13 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 one hour. These results suggest that the KeyScope has achieved the performance criteria needed for laparoscopic biopsy in LMICs.
