At Insight, we know that getting the best angle of view is the foundation of our work. Without getting the shot, we wouldnt have a business. Surgery is a particularly tricky place to test the skills of the videographer, because a good one-third of ones abilities is dependent upon how well one knows surgery and the procedures. The other two-thirds has more to do with ones video talents and the equipment involved.
Generally, video equipment is improving year by year. However, the improvements are headed in directions that are not necessarily improvements for shooting surgery. At Insight, what we have found is that in order to specialize in capturing procedures from the best vantage points, we had to actually invent and build some of the devices on our own. Insight has managed to create a jib arm that is especially suited for the surgical arena, that can hoist a remotely controlled camera in any position above the wound, without the need for hand adjustments in the middle of surgical procedures. We call this jib arm SurgiCam and will sometimes refer to it as our wound camera, although all our cameras are wound cameras at times.
The heart of the design of SurgiCam is that it is specifically designed for surgery, for positioning over the patient; it does not require any hand-touching adjustments while over the wound; zoom, focus, pan, and tilt are remotely controlled from the video engineers station in the corner of the room; it is easily moved in and out of position and lives above headline, so circulators dont bump their heads; and it can be quickly deconstructed into transportable pieces. Having a mobile, transportable unit is especially important, since most of Insights programs are shot at hospitals coast to coast.
SurgiCam has become such a workhorse over the years that Insight has also implemented another jib arm for our production camera. This arm is called the PortaJib since it folds up into a compact little bundle, and is just as easy to transport as SurgiCam. PortaJib gives us fantastic moving shots and can be repositioned at the snap of a finger. PortaJib is especially good for those procedures that have so many steps from different vantage points, that quick mobility and repositioning of the camera is the only way to capture all of the details, without slowing the surgeon or the procedure down.
Another advantage of using jib arms is that it is much easier moving around the surgeons head. However, both jib arms are not always used together on every procedure. SurgiCam is a great utility for capturing wounds from the straight above vantage point, such as open heart surgery, laparotomy, spinal surgery, total joint procedures, and plastic & reconstructive procedures. PortaJib captures most everything for endoscopic procedures and surgery on extremities.
Here are examples of video stills taken from a few procedures where both cameras are used together. Please forgive us for the image quality. If you have glanced at Insights Gallery, you know that transfering video to still pictures does not show the crystal-clear video image quality that was originally in the video. The reason for this has to do with dots per inch and analog to digital, which will hopefully one day not transfer clear images into blurry ones. This example shows two frames taken from a unicompartmental knee replacement shot in the Palm Springs area using both arms.
Notice that SurgiCam, positioned up high, at the proper angle provides a great shot of the tibial plateau, and the PortaJib looks straight up at the femoral condyle. Actions that happen on both planes are covered. Here is another example on the same case:
In this next case of a live-satellite broadcasting of an open hysterectomy and radical abdominal node dissection, the SurgiCam takes care of the over-the-head views, and PortaJib adapts quickly to the specimen dissection at the back table.
This live-event broadcasting is a yearly event, and these shots were taken at Insight Surgicals first year at this event. The surgeon, who was not looking at the monitor of our shots, but like a good surgeon, was looking at the wound, commented to the audience, You probably cant make out any of this anatomy here, but here is the left iliac... Later, the surgeon reviewed the program and was shocked at the degree of improvement in visualization over the previous years, the years before they used Insight. Dont forget that the video images look stunning compared to the stills you see on this page.
Using equipment specifically designed to shoot surgery is not the only way to capture footage in the OR, but it is the best way to do it. At the same time, using great equipment in surgery will not make a better cameraman of an individual that does not know the surgical procedure. Just as it is with the profession of surgeons, it is the mind behind the instrument that dictates the skill of execution. The same holds for video production in surgery.