Photo- and video-documentation of gastrointestinal endoscopy in underresourced settings

A visual record of standardised anatomical landmarks and specific pathology in gastrointestinal endoscopy is now considered by international endoscopy and gastroenterology societies as a mandatory component of the procedural report.^1-4 Photo and video documentation of gastrointestinal endoscopy procedures accurately monitor key performance indicators (KPAs) for trainees and consultants, which are essential to assess the attainment and maintenance of competency. In addition, visual documentation is an excellent adjunct for feedback during training, enables remote teaching and mentorship, is essential for multidisciplinary teams (MDTs) and the conducting of clinical audits, and may be invaluable for medicolegal purposes. The endoscopy equipment of all the major manufacturers in South Africa (Fuji Film, Olympus and Pentax) allows for image capturing directly from buttons on the control handle to a Universal Serial Bus (USB) flash drive. The flash drive can be used to transfer images, and in some instances video, to a reporting computer, but involves time-consuming manual transfers. Some systems have polaroid reproduction systems which are usually single-print photographs attached to reports and generally only document pathology. Commercial medical video hardware and software technology is costly. For example, one of the manufacturers has reporting software and hardware, at a cost of about ZAR 250 000 per stack, that allows direct video and image capture.⁵ S uch major costs highlight the major hurdle to routine photo or video documentation in under-resourced settings. We describe the development in the Groote Schuur Hospital Gastrointestinal Unit of a simple, low-cost method of stillimage and video capture that can be set up on current endoscopy equipment to provide routine still-image and video capture. This system makes use of inexpensive hardware and open access software. It has been implemented and is in routine use for oesophagogastroduodenoscopy, colonoscopy, and advanced interventional endoscopy.