Documenting Surgical Procedures Photographically

摘要

Introduction: In the Netherlands each year 1.5 million surgeries are performed, which are recorded by means of operative notes. As a rule operative notes are still (hand) written subjective testimonies of performed actions, preferably written after surgery. Technology creates the possibility to add video and photo print (image) easily to the operative notes. As images provide extra information, this could improve the operative notes' quality. The aim of this study was to compare photographic parameters (resolution, contrast, brightness, colours, and exposure) and position of digital cameras during an open surgical procedure. Materials and Methods. In the Erasmus University Medical Center-Skills Lab nine pictures of an euthanized pig's bowel were taken using three types of digital camera's: C1) Panasonic-Lumix-DMC-LS2, C2) Fuijfilm-FinePix-S5800, and C3) Nokia-N73 with Carl Zeiss Lens. The cameras (on a tripod) were first positioned at the foot end (F), then at the side (S) and finally above (A) the bowel. Pictures of C1 were transferred to laptop 1, C2 to laptop 2, etc. by means of USB2. Three identical laptops were used for picture viewing (IBM T60). Physicians and medical students were addressed to participate in the study answering several questions: Which view: is most informative?, is the least informative?, portrays the bowel adequately?. In addition, participants had to rank (1-5): resolution, contrast, brightness, colours, exposure, and adequacy of the bowel's image. Results. In total 26 respondents (8 physicians and 18 students) participated in the study (age 19-45, average 27, STDEV=8.4). Viewpoint A was considered most informative (n=16), followed by F and S (both n=5). Viewpoint F was least informative (n=14), followed by A (n=7), and S (n=5). Viewpoint S portrayed the image of the bowel most adequately (n=18), followed by F (n=8). C2 had the highest rating for resolution (cumulative score) 113 points, contrast (99), brightness (94), colours (109), exposure (101), and adequate image of the bowel (107). C1 scored second best with 80, 71, 74, 90, 85, 91 points respectively. C3 had the lowest rating; 73, 71, 63, 78, 68, 75 points respectively Conclusion. This study showed that a high-resolution-camera is better and the view from above is best for capturing pictures of surgical procedures. This seems logical because most surgeons actually perceive structures mainly from above. As camera properties are improving, transferring data becomes faster, storage capacity increased, monitor resolution improving, software more intuitive and electronic patient records are being introduced, pictures could be added to the operative notes more easily.