Videoendoscopy is based on 30-year-old CCD technology developed for broadcast TV which precludes radical innovations. These limitations include 1) expensive 2) fragile 3) require xenon light (high heat, limited life, fiberoptic cables) 4) require camera and couplers 6) stick-like scope configuration or poor quality fiberoptic scope. This study is a proof of concept clinical validation of a new digital chip-based sensor self-containing an illumination system which overcomes these limitations. CMOS sensors unlike CCDs have several transistors at each pixel and read each pixel individually. LEDs produce light on semiconductor chips with life span of transistors and negligible heat production. A flexible digital endoscope was developed with a 3mm distal CMOS chip and integrated white light illumination via phosphor coated LEDs eliminating the light source, its cables and calibration, and camera. Private infertility practice. Patients undergoing operative infertility hysteroscopy. Flexible digital CMOS/LED hysteroscope was tested in a range of clinical cases. Testing was proof of concept design validation. Further testing focused on resolution and light sensitivity and subjective clinical ease of use. The integrated digital scope successfully performed hysteroscopic procedures. Image quality was excellent and fine structures were identified. Procedures including polyps, adhesions, and tubal cannulation were performed. Performance was similar to traditional scope-camera-bulb illumination system with increased ease of use. This hysteroscope radically differs from previous designs. It has no light cables, camera head, couplers, incandescent bulbs, heat production, nor fiberoptics. It has a CMOS-chip with integrated digital signal processing and self-contained LED illumination system. This design enables innovation and creation of future radically different systems. Further refinements will allow the development of a wireless scope since minimal power is required and illumination cables are not. As CMOS chip size is reduced and LED intensity increases remote micromachine imaging devices can be designed and traditional scopes eliminated.
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