Article

A Useful Tool for Intraoperative Photography: Underwater Camera Case

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Abstract

The use of cameras in the operating room is increasing. However, there is not always a free person or an assistant who is familiar with your camera. In order to take faster and high quality photographs in the operating room, we use under water camera cases. These cases are produced for each type of camera and can be gas sterilized prior to operation.

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... Subsequent studies showed that premade plastic waterproof camera cases could be sterilized by using ethylene oxide gas and then used to cover inexpensive digital cameras for intraoperative photography by physicians. 11,12 This practice has not been reported in veterinary medicine and likely remains underutilized. Training programs have also recognized that video documentation of surgical technique is an essential component for the development of psychomotor skills, adding several new dimensions to the previous use of still images. ...
... Unfortunately, malleable covers are known to affect image quality negatively by distorting the image. Only 1 published study has evaluated the safety of reusing solid waterproof camera cases, 11 although these investigators used a less rigorous model for testing the sterilization process, simply using the cameras in plastic surgery procedures classified as "clean" by the Centers for Disease Control Wound Classification System (http://www.cdc. gov/hicpac/SSI/table7-8-9-10-SSI.html) and culturing the camera cover after each resterilization. ...
Article
Objective: To evaluate the safety and usability of a wearable, waterproof high-definition camera/case for use in surgical image acquisition by sterile personnel. Study Design: An in vitro model was used to study the efficacy of bio-decontamination of camera cases. Usability for intraoperative image acquisition was assessed in clinical procedures. Methods: Two waterproof GoPro Hero4 Silver camera cases were inoculated by immersion in media containing Staph. pseudointermedius or E. coli at ≥ 5.50E+07 colony forming units/mL. Cases were biodecontaminated by manual washing and hydrogen peroxide plasma sterilization. Cultures were obtained by swab and by immersion in enrichment broth, before and after each contamination/decontamination cycles (n=4). The cameras were then applied by a surgeon in clinical procedures using either a headband or handheld mode and were assessed for usability according to 5 user characteristics. Results: Cultures were negative for all post-sterilization swabs. One of 8 cultures was positive in enrichment broth, indicating a low level of contamination in 1 sample. Usability of the camera was considered poor in headband mode, with limited battery life, inability to control camera functions and lack of zoom function affecting usability. Hand held operation of the camera by the primary surgeon improved usability, allowing close-up still and video intraoperative image acquisition. Conclusions: Vaporized hydrogen peroxide sterilization of this camera 23 case is considered effective for biodecontamination, although thorough manual washing is recommended. Hand held operation provided optimal usability for intraoperative photography. Clinical Significance: Sterilization of a waterproof camera may provide a low cost method for intraoperative image documentation.
... To take pictures in a sterile medium, gas sterilised underwater camera cases may be used with almost no added infection risk. [1][2][3] However, we are in the era of smartphones and cameras are used less than they were in the past. We need solutions for smartphones for intraoperative photography. ...
... Of the reconstructive options, microsurgical reconstruction of the breast using deep inferior epigastric artery perforator flap is one of the commonly performed procedures. [1] The donor vessels for the flap are either the internal mammary artery or its perforator and the thoracodorsal vessels. The internal mammary perforator's size is not predictable also access to internal mammary vessels need removal of costal cartilage and is technically difficult. ...
Chapter
Photographing surgical procedures is sometimes required for documenting techniques and for patient record. It is a powerful tool for teaching, and it can complement drawings and animations. It is important to keep safety aspects present both regarding the patient, the photographer, and the surgeons.
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Intraoperative photography is used to obtain images for both education and research purposes, but poses challenges due concerns regarding aseptic technique. Waterproof digital cameras have sterilisable cases that can be used by the surgeon for intraoperative photography. We compared the quality of still intraoperative images obtained by a non-scrubbed observer using a 35 mm single lens reflex (SLR) camera to images obtained by the surgeon using a GoPro camera in a sterilised case. Image quality was scored using a 4 point Likert scale by 3 groups of end users with differing experience: faculty surgeons, surgical residents, and 3rd year veterinary students. Mean ± SEM overall image quality scores were higher for the traditional 35 mm digital SLR camera when compared to the GoPro (3.25 ± 0.08 vs. 2.0 ± 0.08, p < .0001), as were scores for each image characteristic (brightness, colour, sharpness, and contrast). Image quality scores for each camera also differed significantly between user groups, with expert users (faculty and residents) giving lower quality scores when compared to scores from novices (students). Findings suggest that GoPro cameras provide lower intraoperative image quality than digital SLR cameras, although lower quality images may be more accepted by novices than by experienced users.
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Article
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