Scope Towers

[Peruano]

Looking into private practice jobs, and I'm realizing how amazingly decked out academic ENT clinics are with gear. Most of the practices I'm seeing don't use a tower for their scopes. Obviously I'm used to this because it's how we do inpatient consults at my institution, but I like using a tower for showing patients and family what I see, and for documentation.

Anyone know a ballpark of what towers cost, from an old generation used one to a fancy-pants 4k? i would think i'd just get a couple of cheap ones for the rooms I work.

Same thing for ear microscopes (cost estimate from used and old to brand new).

I'm assuming that if I wanted such things in my clinic, and the partners didn't care for it, I would just have to pay for it myself, right? it's not like Leica is just gonna give me a scope for a year or something.

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[operaman]

Depends on the brand and the specifics of what you want. I think ours go for around $120-150k per tower. Not sure if that’s list or discounted or what.

You can probably call a rep or two and ask about a quote.

 

[DoctwoB]

Honestly if youre starting from scratch its probably much cheaper/easier to buy ambu-scopes and their little tablet screen.

 

[OtoHNS]

Depends on the brand and the specifics of what you want. I think ours go for around $120-150k per tower. Not sure if that’s list or discounted or what.

You can probably call a rep or two and ask about a quote.

Holy cow, it seems hard to justify that price tag unless it’s for a 100% laryngology practice with high volume of stroboscopy and office based laryngeal procedures.

I find the price is right ($0) and the view of the larynx is more than adequate by looking in the eyepiece of the scope. Of course, I’d be the one footing that $150k bill if I bought one of those towers.

 

[HighPriest]

Here are the reasons to own a video tower:

1-you want to look at the videos
2-your patients want to look at the videos.

That’s all.

#2 is usually true but it’s easy for them to say when they don’t have to pay any extra. It’s a free picture at the end of the water ride.
#1 is probably helpful if you’re (as mentioned already) doing a lot of laryngeal microsurgery or you run a aesthetic day spa for voices. But for me at least here’s how 99% of my dysphonia consults go:

Me:
“We’ll, good news, you don’t have cancer.”

Patient:
“Ah, great. Well, back to smoking and eating a full rack of ribs in the bed, then.”

Me: “well…would you be interested in trying to not do those things, or some PPIs, or seeing a voice therapist?”

Patient: “huh? Why?”

Me: “no reason. Have a good day.”

99 year old church ladies aside. They’ll see SLP.


It can theoretically be helpful if you refer a patient and can send a video or if you have a cloud drive that SLP can use, but I assure you that all of that works without the video or the cloud, both of which are paid for separately.

 

[operaman]

Holy cow, it seems hard to justify that price tag unless it’s for a 100% laryngology practice with high volume of stroboscopy and office based laryngeal procedures.

I find the price is right ($0) and the view of the larynx is more than adequate by looking in the eyepiece of the scope. Of course, I’d be the one footing that $150k bill if I bought one of those towers.

Agreed. I’m definitely in the high volume strobe category and the video quality makes a huge difference so it makes sense for my practice. They’re also all purchased with institutional money earmarked to help build this practice; it would be a hard sell if it was just me hanging out my shingle. A crappy strobe and a beautiful distal chip 4K strobe bill exactly the same.

I think most of the other practices in my area just do eyeball scopes or at most, connect a camera to a fiberoptic scope based on the screen door pictures I see scanned into the chart. Works for most consults, and anything else they just send to me.

 

[UncleMinnie]

Also interested in this as a resident going into general practice. I feel like It's not bad for laryngology to use the scope eyepiece. However, when I'm debriding or doing small procedures for rhinology patients, I would prefer to not have my face directly in front of their nostril looking in an eyepiece while they sneeze on me, and would be super interested in an economical tower.

ENT needs a company like Spirit Airlines in terms of quality/price point for products for when I'm getting started.

 

[OtoHNS]

Also interested in this as a resident going into general practice. I feel like It's not bad for laryngology to use the scope eyepiece. However, when I'm debriding or doing small procedures for rhinology patients, I would prefer to not have my face directly in front of their nostril looking in an eyepiece while they sneeze on me, and would be super interested in an economical tower.

ENT needs a company like Spirit Airlines in terms of quality/price point for products for when I'm getting started.

My experience is that sneezes always come with enough warning to get out of the way. Bursts of coughing can come very suddenly though, especially when the patient has some sedation on board.

I've continued wearing a mask for sinus procedures in the office for this reason.

 

[Wordead]

Also interested in this as a resident going into general practice. I feel like It's not bad for laryngology to use the scope eyepiece. However, when I'm debriding or doing small procedures for rhinology patients, I would prefer to not have my face directly in front of their nostril looking in an eyepiece while they sneeze on me, and would be super interested in an economical tower.

ENT needs a company like Spirit Airlines in terms of quality/price point for products for when I'm getting started.

Storz and Stryker have both been peddling a mobile small unit with reusable scopes and one of them is supposedly able to do a strobe exam. It's substantially cheaper than the Olympus towers that we use (which are very very nice). I have not used those units since I already have good equipment but figured it'd be something for you to look into.

I don't know anyone using a 4K screen/camera in the office. That seems like overkill. It's not even necessary in the OR though very satisfying and preferable to me.

 

[operaman]

Storz and Stryker have both been peddling a mobile small unit with reusable scopes and one of them is supposedly able to do a strobe exam. It's substantially cheaper than the Olympus towers that we use (which are very very nice). I have not used those units since I already have good equipment but figured it'd be something for you to look into.

I don't know anyone using a 4K screen/camera in the office. That seems like overkill. It's not even necessary in the OR though very satisfying and preferable to me.

Olympus loaned us some 4K screens for the office and they suuuuuck. Unfortunately if you pair regular distal chip scopes and 4K screens, it just looks more grainy.

The higher res distal chip scopes come at the cost of increased diameter which is obviously an issue for patients. The pictures are nice though, but not so much better that I’m clamoring for a whole 4K setup. Instead I focused on strobes and working channel scopes.

I hope that portable Storz is better than their old portable. We had one at our VA in residency and it was pretty terrible.

 

[Dr McSexy]

I find the ability to record and show back videos is nice. I often like to look back at prior endoscopy exams, compare and note progression/regression, show patients etc.. Yeah you can't bill more but the patient experience is better. Not everything has to be a strictly profit/loss margin.

With that said, a full set up like you in residency is expensive. I can't quite remember the numbers but a solo Olympus tower set up with a distal chip scope was about 50k, tack another 12k for a a strobe scope.

Storz can be cheaper but depends on the set up. That have portable telepack units that have lesser video quality but ability to store on system and playback either on system(depends on which version) vs playback to a computer. It's an all in kit but I think about half the cost of Olympus. If all you want and record and play back action in a plug and play scenario it's pretty good.

You can also piece meal components of storz with a similar set up to their OR equipment(i.e. get their light box, recording box, video processor box, hd camera cord etc). Obviously adds up, then tack on another 5k -10k per scope depending fiberoptic vs distal chip. (Pro tip buy cheap used sigmoidscopes or what not on ebay and trade them in for a discount)

Lastly you could rig up a serviceable set up on your own on non medical equipment aside from the scopes and camera cords, and do play back, storage etc. Little bit trickier buy have heard of people doing that with some success.