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Huang XY, Shao Z, Zhong NN, Wen YH, Wu TF, Liu B, Ma SR, Bu LL. Comparative analysis of GoPro and digital cameras in head and neck flap harvesting surgery video documentation: an innovative and efficient method for surgical education. BMC MEDICAL EDUCATION 2024; 24:531. [PMID: 38741079 DOI: 10.1186/s12909-024-05510-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 05/02/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND An urgent need exists for innovative surgical video recording techniques in head and neck reconstructive surgeries, particularly in low- and middle-income countries where a surge in surgical procedures necessitates more skilled surgeons. This demand, significantly intensified by the COVID-19 pandemic, highlights the critical role of surgical videos in medical education. We aimed to identify a straightforward, high-quality approach to recording surgical videos at a low economic cost in the operating room, thereby contributing to enhanced patient care. METHODS The recording was comprised of six head and neck flap harvesting surgeries using GoPro or two types of digital cameras. Data were extracted from the recorded videos and their subsequent editing process. Some of the participants were subsequently interviewed. RESULTS Both cameras, set at 4 K resolution and 30 frames per second (fps), produced satisfactory results. The GoPro, worn on the surgeon's head, moves in sync with the surgeon, offering a unique first-person perspective of the operation without needing an additional assistant. Though cost-effective and efficient, it lacks a zoom feature essential for close-up views. In contrast, while requiring occasional repositioning, the digital camera captures finer anatomical details due to its superior image quality and zoom capabilities. CONCLUSION Merging these two systems could significantly advance the field of surgical video recording. This innovation holds promise for enhancing technical communication and bolstering video-based medical education, potentially addressing the global shortage of specialized surgeons.
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Affiliation(s)
- Xin-Yue Huang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhe Shao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral & Maxillofacial - Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Nian-Nian Zhong
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yuan-Hao Wen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Tian-Fu Wu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral & Maxillofacial - Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bing Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral & Maxillofacial - Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Si-Rui Ma
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Oral & Maxillofacial - Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Lin-Lin Bu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Oral & Maxillofacial - Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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Haddock NT, Teotia SS. Efficient DIEP Flap: Bilateral Breast Reconstruction in Less Than Four Hours. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3801. [PMID: 34513542 PMCID: PMC8423400 DOI: 10.1097/gox.0000000000003801] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/01/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The DIEP flap is considered the gold standard in autologous breast reconstruction. Despite the benefit of a lifelong natural reconstruction, some argue that the potential drawbacks, specifically operative time and recovery, are significant. We recently focused specifically on process analysis in our DIEP flap practice and present a comprehensive analysis in efficient DIEP flap breast reconstructions. METHODS Fifty consecutive bilateral DIEP flaps were prospectively tracked (100 flaps). The procedure was divided into segments (recipient site preparation, DIEP flap dissection/harvest, microsurgery, breast shaping, and abdominal closure). All individual step times were recorded for each team member. Relevant patient characteristics, intraoperative details and postoperative outcomes were recorded. RESULTS Average surgical time was 3 hours and 58 minutes (the fastest time recorded was 2 h and 14 min). There were no immediate postoperative complications. The anastomotic revision rate was 6%. Four surgeons contributed 34.7% of the time, three surgeons 32.2% of the time, two surgeons 23.6% of the time, and one surgeon 4.8% of total time. In procedures under 4 hours, four surgeons contributed simultaneously 36.7% of the time compared to 21.8% in the longer procedures (P = 0.004). Four surgeons contributed 45.4% of the time (P = 0.01) in the sub-three-hour bilateral DIEP flap procedures. CONCLUSIONS Efficient DIEP flap breast reconstruction can be accomplished with a well-trained and coordinated team approach involving like-minded surgeons with extensive experience working together. The synergistic map shows constant movement with utilization of hidden time, without sacrificing education, outcomes, or innovation.
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Affiliation(s)
- Nicholas T. Haddock
- From the Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Tex
| | - Sumeet S. Teotia
- From the Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Tex
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Deconstructing the Reconstruction: Evaluation of Process and Efficiency in Deep Inferior Epigastric Perforator Flaps. Plast Reconstr Surg 2020; 146:816e-817e. [PMID: 33234984 DOI: 10.1097/prs.0000000000007400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Azari DP, Miller BL, Le BV, Greenberg CC, Radwin RG. Quantifying surgeon maneuevers across experience levels through marker-less hand motion kinematics of simulated surgical tasks. APPLIED ERGONOMICS 2020; 87:103136. [PMID: 32501255 DOI: 10.1016/j.apergo.2020.103136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 06/11/2023]
Abstract
This paper compares clinician hand motion for common suturing tasks across a range of experience levels and tissue types. Medical students (32), residents (41), attending surgeons (10), and retirees (2) were recorded on digital video while suturing on one of: foam, pig feet, or porcine bowel. Depending on time in position, each medical student, resident, and attending participant was classified as junior or senior, yielding six experience categories. This work focuses on trends associated with increasing tenure observed from those medical students (10), residents (15), and attendings (10) who sutured on foam, and draws comparison across tissue types where pertinent. Utilizing custom software, the two-dimensional location of each of the participant's hands were automatically recorded in every video frame, producing a rich spatiotemporal feature set. While suturing on foam, increasing clinician experience was associated with conserved path length per cycle of the non-dominant hand, significantly reducing from junior medical students (mean = 73.63 cm, sd = 33.21 cm) to senior residents (mean = 46.16 cm, sd = 14.03 cm, p = 0.015), and again between senior residents and senior attendings (mean = 30.84 cm, sd = 14.51 cm, p = 0.045). Despite similar maneuver rates, attendings also accelerated less with their non-dominant hand (mean = 16.27 cm/s2, sd = 81.12 cm/s2, p = 0.002) than senior residents (mean = 24.84 cm/s2, sd = 68.29 cm/s2, p = 0.002). While tying, medical students moved their dominant hands slower (mean = 4.39 cm/s, sd = 1.73 cm/s, p = 0.033) than senior residents (mean = 6.53 cm/s, sd = 2.52 cm/s). These results suggest that increased psychomotor performance during early training manifest through faster dominant hand function, while later increases are characterized by conserving energy and efficiently distributing work between hands. Incorporating this scalable video-based motion analysis into regular formative assessment routines may enable greater quality and consistency of feedback throughout a surgical career.
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Affiliation(s)
- David P Azari
- Department of Industrial and Systems Engineering, 1550 Engineering Drive, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Brady L Miller
- Department of Urology, Third Floor, 1685 Highland Avenue, University of Wisconsin-Madison, Madison, WI, 53705, USA
| | - Brian V Le
- Department of Urology, Third Floor, 1685 Highland Avenue, University of Wisconsin-Madison, Madison, WI, 53705, USA
| | - Caprice C Greenberg
- Wisconsin Surgical Outcomes Research (WiSOR) Program, Department of Surgery, Clinical Science Center, 600 Highland Avenue, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Robert G Radwin
- Department of Industrial and Systems Engineering, 1550 Engineering Drive, University of Wisconsin-Madison, Madison, WI, 53706, USA; Department of Biomedical Engineering, 1415 Engineering Drive, University of Wisconsin-Madison, Madison, WI, 53706, USA.
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Saun TJ, Zuo KJ, Grantcharov TP. Video Technologies for Recording Open Surgery: A Systematic Review. Surg Innov 2019; 26:599-612. [PMID: 31165687 DOI: 10.1177/1553350619853099] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Video recording of surgical procedures is an important tool for surgical education, performance enhancement, and error analysis. Technology for video recording open surgery, however, is limited. The objective of this article is to provide an overview of the available literature regarding the various technologies used for intraoperative video recording of open surgery. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines using the MEDLINE, Cochrane Central, and EMBASE databases. Two authors independently screened the titles and abstracts of the retrieved articles, and those that satisfied the defined inclusion criteria were selected for a full-text review. A total of 2275 publications were initially identified, and 110 were included in the final review. The included articles were categorized based on type of article, surgical subspecialty, type and positioning of camera, and limitations identified with their use. The most common article type was primary-technical (29%), and the dominant specialties were general surgery (22%) and plastic surgery (18%). The most commonly cited camera used was the GoPro (30%) positioned in a head-mount configuration (60%). Commonly cited limitations included poor video quality, inadequate battery life, light overexposure, obstruction by surgical team members, and excessive motion. Open surgery remains the mainstay of many surgical specialties today, and technological innovation is absolutely critical to fulfill the unmet need for better video capture of open surgery. The findings of this article will be valuable for guiding future development of novel technology for this purpose.
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Affiliation(s)
- Tomas J Saun
- 1 St Michael's Hospital, Toronto, ON, Canada.,2 University of Toronto, ON, Canada
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Bello RJ, Major MR, Cooney DS, Rosson GD, Lifchez SD, Cooney CM. Empirical validation of the Operative Entrustability Assessment using resident performance in autologous breast reconstruction and hand surgery. Am J Surg 2017; 213:227-232. [DOI: 10.1016/j.amjsurg.2016.09.054] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 08/22/2016] [Accepted: 09/07/2016] [Indexed: 11/24/2022]
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