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Hysterectomy through the looking glass: iHysterectomy frugal by iPhone
  1. Jan Baekelandt1,
  2. Jan Bosteels2
  1. 1Department of Gynaecological Oncology and Endoscopy, Imelda Hospital Bonheiden, Bonheiden, Belgium
  2. 2CEBAM, The Centre for Evidence-based Medicine, Cochrane Belgium, Academic Centre for General Practice, Leuven, Vlaanderen, Belgium
  1. Correspondence to Dr Jan Baekelandt, Department of Gynaecological Oncology and Endoscopy, AZ Imelda Hospital, Imeldalaan 9, Bonheiden 2820, Belgium; jan.baekelandt{at}


This study aims to demonstrate the feasibility of a frugal approach to an endoscopic hysterectomy: the iHysterectomy. An iPhone with endoscope-i adaptor and a portable light source were used instead of a laparoscopic camera, video processor, monitor and light source. A vaginally assisted natural orifice transluminal endoscopic surgery (NOTES) hysterectomy (VANH) was performed by Poor Man's NOTES technique using a self-constructed glove port and standard reusable instruments. Ten iHysterectomies were successfully performed by a single surgeon (JBa). No conversion to a laparoscopic tower, standard multi incision laparoscopy, or laparotomy was necessary. Mean operation time was 52 min (40–75); mean serum haemoglobin drop was 0.8 g/dL (0.2–2.1). There were no operative complications, and postoperative pain scores were low. The iHysterectomy technique enables surgeons to perform a minimally invasive hysterectomy in a low-resource setting without the need to invest in a laparoscopic tower. The investment required for endoscopic hardware is a fraction of that for conventional laparoscopy or robotic surgery. This is an Idea Development Exploration Assessment Long-term (IDEAL) stage 1 study: iHysterectomy is a novel approach requiring further validation. This is the first report on the use of an iPhone to perform a hysterectomy or any other major operation.

  • Frugal
  • Gynaecology
  • Affordable

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  • Contributors JBaekelandt adeveloped the iHysterectomy technique, conceived the study, operated all the patients, collected the data and wrote the paper. JBosteels reviewed the paper.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.