How to Shoot and Edit High-Quality Surgical Videos ?

A surgical video can improve patient care, surgical education, as well as scientific presentations and publications. With continuous technological improvements in video filming hardware and editing software, multiple options for producing high-quality surgical videos are available.

The article by James R. Mullen et al in 'journal of hand surgery Am' describes the important aspects of filming and editing videos to create a video that the surgeon can watch before performing the procedure. The authors reviewed camera terminology, including resolution, optical and digital zoom, shutter speed, and frame rate, as well as equipment options or setup for recording high-quality surgical videos.

They provided information regarding computer requirements and editing on Windows and Macintosh operating systems, optimizing educational value for the viewer.

Key points for successful video recording:

• Frame your shot prior to prepping and draping, which includes setting the image POV, chair and table heights, patient's arm or hand position, and OR lights.

• Use a stable mount that minimizes ancillary motion.

• Zoom in as much as possible without sacrificing resolution.

• Surgical videos should be recorded with a minimum resolution of 1,080 p. Thirty frames per second is standard and ideal for shooting most surgical videos. The ideal video shutter speed is approximately double the frame rate. Therefore, for recording at 30 frames per second, the shutter speed should be 1/60th of a second.

• Appropriate lighting is critical for shooting an excellent surgical video.

• Operating room lights that are too bright may lead to overexposure or shadowing, which is very difficult, if not impossible, to correct with video editing after production.

• Neutral-density filters can be used while shooting in bright light to avoid overexposure.

• Homogeneous lighting is better than focused lighting for the purpose of shooting a video. Therefore, defocus the OR lights onto the entire surgical field as opposed to the incision only. This results in less variation in lighting intensity.

• Use of dark-colored gloves and background (towels) while avoiding white background material (reduces glare).

• Try to keep the body part clean, and remove dried blood frequently.

• Remove lap sponges and Raytecs from the surgical field, and replace towels when they become soiled.

• In general, a dry field reduces image glare.

• During video shooting, have someone periodically check to ensure that the video is getting recorded and that the image remains centered.

• While recording procedures that involve arthroscopy, an external video demonstrating portals and equipment should be viewed with the arthroscopy video. This can be made using the picture-in picture concept so that the viewer is able to see the external video as well as the arthroscopy video.

Universal tips for video editing:

• Ideally, an i7 multicore processor or a better version with a minimum of 32 GB of random-access memory is needed. A good graphics card, 1-TB solid-state drive operating system, and 4-TB disk drive storage are also required for the editing of a 4K video.

• For editing 1,080 p videos, a less powerful system will suffice.

• Remove the audio from the video files.

• Crop (functions like zoom) the image as much as possible so that the incision takes up the entire screen without compromising resolution.

• Compliance with the Health Insurance Portability and Accountability Act is required: any visual identifiers specific to the patient (tattoos, anatomic anomalies, birthmarks, and scars) should be blurred out during the editing process.

• Audio can be inexpensively recorded using a standard headphone with a built-in microphone. The addition of a "pop" filter avoids excessively percussive consonants and mellows the overall dialogue. Voice overs can be recorded as a voice memo on a smartphone and imported to the video. In most video-editing software, it is possible to record audio directly through the editing program.

• It may be useful to watch the entire video a few times before recording to rehearse the timing of pairing the audio with the visual.

• Once finished, convert the video to .mp4 format, which is a universal format.

Further reading:

How to Shoot and Edit High-Quality Surgical Videos for Hand and Upper Extremity Surgery

James R. Mullen, Ramesh C. Srinivasan, David V. Tuckman, Warren C. Hammert.

J Hand Surg Am. 2022;47(5):471-474.

https://doi.org/10.1016/j.jhsa.2021.09.021