Abstract

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.