Current systems for filming open surgery utilize a variety of methods such as head mounted cameras, surgical light mounted cameras, and portable filming setups. At TVASurg we seek to utilize whatever methods will give us the best result for the given assignment, and different types of procedures call for different methodologies.

Whenever you discuss filming surgery with someone, frequently the first idea that comes up is head mounted cameras, such as a GoPro. Head-mounted cameras allow the surgeon to capture their own point of view, and for tight spaces and small surgical exposures, this can sometimes be the only way to get footage of the operative field. Unfortunately, head-mounted cameras frequently produce shaky and thus nauseating footage. Even if you do take the time-consuming approach of motion-tracking the footage to correct for the camera shake, you will still have motion blur as a result, and this makes the footage less than optimal. So, while head-mounted cameras can contribute unique shots to a final video, they are almost never the sole solution to OR filming.

One method of removing camera shake while maintaining flexibility in camera position is by using camera stabilizers such as gimbals, or gimbal camera systems like DJI Osmo cameras. Gimbals allow you to move a camera in smooth continuous motions without unpleasant and distracting, jittery movements. The Osmo Pro camera we sometimes use is controlled with a smartphone through an app. These unique cameras offer an increased range of flexibility, are the best option for capturing transitions from one operative location to another, and the newest models offer high quality 4K formats.

Sometimes it’s not the camera itself but augmentation that makes all the difference. A unique tool utilized in photography and videography is the monopod, which is a single long pole a camera unit can be fixed to. A monopod can allow for a videographer to capture difficult angles, but requires a person to hold it at all times, and does not completely eliminate subtle camera movements. In surgeries where the operative field changes, such as in ENT free flap reconstructions, a monopod can be useful in an OR environment where the angles of view are rapidly shifting.

For the best possible results in filming surgery, you want at least one fixed-position camera. The traditional camera tripod is a straightforward method to achieve this, but in the majority of OR environments, the vertically fixed placement of the camera above a stationary support limits the camera’s point of view. In open HPB surgeries, the recommended approach is to use a laparoscopic HD camera mounted on a mechanical arm fixed to the OR bed, as described in a 2013 AHPBA presentation, and in a 2007 paper in the journal Annals of Surgery. For our filming setup, we have one camera thatʼs secured to the surgical bed, which is draped in a sterile cover, and an overhead camera that is attached to overhead equipment, also draped with a sterile cover. We published a comprehensive description of our filming methodology in a 2016 paper in the Journal of Visual Communication in Medicine.