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Blog: Surgical Video: The Sequel

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Mike CohenBlog: Surgical Video: The Sequel
by on Feb 15, 2012 at 4:27:03 am

A few years ago I was honored to write the following article for Creative COW Magazine.

Ever since, after countless nice comments on the article, and as the world of operating room video has caught up with high definition media production, I've wanted to do a proper follow-up article.

This is the start.

When we last spoke, we were starting to shoot HD for open surgery:

Oh, Sony V1U - you seemed like a good camera when you were the first HD camcorder we owned. Had we only known then that 3 1/4" CMOS chips were not such a great invention. The rest of the camera is ok and in well-lit operating rooms works fine. Low light, such as during a minimally invasive (MIS) case - not good at all. I'm honestly surprised they still sell this camera.

Next we got the Sony Z5 - still HDV but for the amount of video we can shoot in a day (8 hours times 3 cameras = a lot of tape or huge amounts of memory cards and a guy with a laptop) it makes sense...for now. Read on.

For a nice juicy sample video of open surgery video, click below:

Fast forward a couple more years and we are shooting plenty of open and MIS cases with a combination of HDV, Canon AVCHD and Canon EOS 7d. Since I've gotten better at manual focusing with the 7d and getting the white balance to balance, it is becoming a favorite B-camera.

If the Z5 is mounted up on the boom and I want a quick shot of some instrument prep or whatever, I'll put the 7d in movie mode and it's like shooting 16mm a few minutes at a time. I see what all the hype is about, and why people get those fancy rigs with follow focus knobs!

Now I have my eye on either the Sony NX5, FS100, F3 or EX3 or likewise the Panasonic AF100 or HPX-170 - luckily you can rent all these cameras in either Boston (RULE) or NYC (Abel Cinetech) or pick a local vendor (DC Camera, MP&E, Bexel - you get the idea) - why buy when you can try!

As far as recording HD from the medical camera or laparoscope, it has been an interesting journey. The first such cameras that came out in the mid-2000's may have been called "HD" but that seemed to stand for "higher-definition." 1150x768 does not HD make. Nowadays medical camera systems are standard HD sizes, although there are also options for resolution to be matched to the LCD monitors used in the room.

Over the past few years a few docs we work with a lot have been sending us DVD's of MP4 HD files, usually recorded overseas. Sometimes you need to convert to an editable file, or using CS4 or 5 import natively and expect long export times.

(this doctor asked if he was going to make the blog - he'll recognize himself I'm sure!)

Most of the manufacturers of medical scopes offer a recording device - each will record to internal hard disk vast quantities of 480i, less of 720 video. I find some OR's keep things set to 480i, feed their monitors with either DVI or...gasp...s-video while others are full HD, though using DVI, not SDI. More on this in a bit.

Recently, with the goal of creating a full HD soup to nuts production, we decided upon the Sound Devices PIX 240 HD recorder. This thing, one of many such devices (KiPro, Ninja, CineDeck), is pretty sweet. In the weeks ahead of the shoot we worked with the in-house media guy, we'll call him Joe, as well as the reps for the manufacturers of the medical cameras, to determine the output options. Remember in the original article I mentioned the importance of working with the local resources - they are extremely helpful especially if you have to navigate someone else's systems. It depends upon the brand. Stryker's camera will output 480i or 720p, or odd resolutions such as 1024x1280 - actually higher than 720p but not necessarily recordable by a broadcast-oriented device. Olympus on the other hand has an HDTV indicator light but no accessible menu controls to change the settings. On the first day, the Olympus system's SDI output was providing 480i. No worries, the PIX240 up-converts in real time to 720p - we'll see how it looks. A device like this is also a great way to make your HDV cameras record solid state, or even to record off of solid state cameras without using a truckload of SxS or P2 media...maybe.

The Stryker device on day 2 was putting out 720p. We also used an Olympus flexible endoscope which was actually providing 1080 over HD-SDI. The PIX 240 took all of these signals and offered to record natively (except the 480i) or would up-rez from 720 to 1080. I kept everything at 720. The HDV of course is 1440x1080 - we'll either edit in 720 or see how the 720 looks in a, HDV sequence (stay tuned for part II).

The PIX240 accepts HDMI and SDI. We used both. The devices that output DVI can be captured with a simple conversion coupler (HDMI is DVI with sound after all).

Each evening is spent backing up files - SD cards, CF card from the 7d and the removable SSD cartridges from the PIX240. It's a number of extra bits and pieces to travel with but better to backup sooner rather than later.

The final piece of the puzzle is the on-camera interview. While I travel with a basic light kit, the cool thing about an OR is it comes with a 3 light kit of its own. This pic shows a softbox for key, reflector for fill and Arri 300 for back light. Other times I'll lose the softbox and I stick with an Arri fresnel 300 with some soft spun, use one of the OR lights as a hair light (although the surgical hat obscures the hair, so it's more of a shoulder light just to give some separation), and then use a gold reflector bouncing another OR light to serve as fill. The 3rd OR light can throw some visual interest on the background. My college mentor used to describe "painting with light" as what you do when you light a scene. This is a decent palette to work with.

Overall, shooting HD surgical video remains a joyous part of my job. Editing is handled by my crew as well as much of the shooting. But it is good to stay in practice and to help our customers achieve their goals. Whether pure education, marketing, training or a combination, we've got you covered.

I hope nobody lost their lunch over this one.

Thanks, as always, for reading.


Mike Cohen

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