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Surgical Video: The Cutting Edge

COW Library : Art of the Edit : Mike Cohen : Surgical Video: The Cutting Edge
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A Creative Cow Magazine Extra


Creative Cow Magazine Extra: A Deeper Look into Medical Video
Mike Cohen Mike Cohen
Woodbury, Connecticut US
© CreativeCOW.net. All rights reserved.

Article Focus: Creative Cow Contributing leader Mike Cohen has been working on the cutting edge of surgical video for years. In this expanded version of his article in the Cow Magazine's "Non-Broadcast Production Issue," Mike answers some of the most frequently asked questions about these techniques from the Cow forums. It's fascinating stuff, but seriously, be sure you've had breakfast before reading this.


Why would someone want a video of surgery? For starters, surgical residents and practicing surgeons like to keep up with the latest techniques. With apologies to the producers of Grey’s Anatomy, you just can’t see much from those galleries above the operations.

Purely educational surgical videos are usually presented at a medical convention, such as the American College of Surgeons or SAGES. Following presentation before an audience of between 20 and 1000 fellow surgeons, DVDs are available for purchase or surgeons can subscribe to a streaming web-based library.

In addition to being purely educational, a video of surgery may also be used for marketing. For example a medical device company may want to promote its latest widget, in the context of a video. In addition to the operation, we may also include a surgeon testimonial, some animation showing the widget’s features and benefits, and finally some interesting text and data depicting the widget’s success and positive patient outcomes. So there, you see, surgical video can also be a marketing video.

Since the Cow is all about production, I will discuss some technical aspects of surgical video. To be honest, I don’t spend a lot of time talking about the latest technology. If you are good at your craft, the technology involved should not really matter.

All you hear about these days is “keyhole surgery”, robotic surgery, minimally invasive surgery, short hospital stays, lower patient morbidity, etc.

Minimally invasive, "keyhole" surgery, including laproscopy

 

I will discuss these topics in a minute. However, some surgery is still done the old fashioned way. Invasive cancer, breast surgery, transplants and large hernias are just a few of the many procedures performed using small or very large skin incisions.

Abdominoplasty - a large "open" surgical procedure

When I started, I had no idea I would one day be so interested in surgical video. I simply took an open position after a job duping tapes. Working with the top surgeons in the field has opened my eyes to some amazing procedures, disturbing diseases and memorable experiences. Here are some of them.

Note: if you have not eaten breakfast, now would be a good time.

Cadaver Dissection is a staple for medical students worldwide. I am not a medical student. While I was not doing the actual dissection, this was the first time I had seen a dead body, and these were, by the way, fresh ones. It was a surreal experience, and I can still see their faces.

Nose Reconstruction remains one of the most amazing operations I have seen. One woman had been living with a prosthetic nose for years, after cancer claimed her original proboscis. This was a four-part operation. In brief, a flap of tissue from the forearm, combined with cartilage from the ear, bone from the rib, skin from the forehead and back were all combined to provide a fairly good looking nose.

Intraperitoneal Chemotherapy – Huh? In patients with serious invasive cancer, where the disease is working at the microscopic level to threaten life, a 12-hour operation first surgically removes visible disease.

Then a reservoir is created in the abdomen, covered with plastic sheeting. A pump circulates heated chemotherapy solution through the abdomen for several hours, killing the cancer you cannot see. Sounds gross, but it works.

In addition to becoming somewhat knowledgeable about surgical techniques, I have picked up some rudimentary medical knowledge along the way.

Close-up view of a suture, ideal for learning to sew buttons

And not surprisingly, I have become pretty good at sewing buttons on my shirts.

 

Tips for Shooting Surgery

Our specialty is documenting open surgery, the kind where they literally open you up. We've done this with everything from a very heavy Ikegami HL-95 with dockable MII deck to the latest Sony HDV cameras. Regardless of the technology involved, the same tricks of the trade apply.

• Eat breakfast – cases often start at 7:30am and go on forever. The sight of guts on an empty stomach is not for everyone.

• White balance. Sounds obvious, but operating rooms generally have banks of fluorescent lights and overhead boom mounted halogen lights – colors that don't match. A head mounted light is yet another color temp, so beware.

• Get the camera as close to the operative field (incision) as possible.

• Don’t touch anything blue. "Blue" in the OR equals "sterile.".

• Make sure all your camera parts are secure. (Insert Seinfeld “Junior Mint” episode reference here.)

• Ask the surgeon to let you know when something important is about to happen. It also helps if the surgeon describes a technique or points out key anatomical landmarks.

• Ask the surgeon to use longer hand instruments if possible.

• Remind the surgeons to clean their gloves if they get really bloody. A 40 foot projection screen can make a messy surgical field look like a disaster.

Bloody gloves

• Develop a good rapport early, so you can get away with saying “Doctor, please get your head out of my way.” Seriously, this is most important.

Once you have seen a lot of surgery, you realize there is a lot of repetition, and that most procedures are a combination of basic skills and techniques combined with expert knowledge to accomplish the surgical goals.

Thus, as you are watching and following the action, you can anticipate is likely to happen next, and zoom in, zoom out or move your camera in anticipation. Again, this is a skill obtained through repetition.

 

Laparoscopic Surgery

Minimally invasive, or “laparoscopic,” surgery is where surgeons become their own cinematographers. Long before extreme sports athletes were strapping lipstick cameras to their helmets and jumping out of airplanes, surgeons have used optical scopes and video cameras to examine body cavities and perform operations.

One of the earliest uses of an optical scope was to examine the bladder, a procedure called cystoscopy. Once color video cameras small enough to use during surgery became available in the 1980’s, the first laparoscopic procedure performed was Cholecystectomy, or removal of the gallbladder.

A clear view of the liver and gallbladder
Liver and gallbladder, center. (This is obviously a view from an "open" surgery rather than a laparoscopic one.)



Once this procedure was established as safe, many other basic and advanced procedures followed.

Early surgical video cameras were single CCD, with expectedly mediocre images. The mediocre image was combined with standard VHS recording. The arrival of 3-CCD cameras and SVHS in the mid-90’s really allowed laparoscopic surgery to thrive and made laparoscopic surgical video available to the masses. Once surgeons started recording all of their procedures, the days of DIY surgical videos began.

Laparoscope
Laparoscope

 

To this day, many laparoscopic video towers found in hospitals around the country, include a digital video recorder. Most of the systems you see in an OR are proprietary medical grade devices, sometimes featuring a hard disc and a CD or DVD burner.

In most cases the output is a CD or DVD with MPEG1, MPEG2, DIVX, Quicktime or other files. Most of the machines currently available spit out an autorun file so when you insert the disc in your computer, you get a HTML menu featuring the patient’s ID number, sometimes the surgeon’s name and thumbnails of all the video files.

This is all well and good, but what if you want to edit your video? Here’s where there can be a problem. You can certainly import various flavors of MPEG or DIVX into your editing system (sometimes) however the technical specs often leave much to be desired.

A recent visit to an OR revealed that their particular video recorder had a very small hard drive, so they used the MPEG1 setting. If using MPEG2, every 30 minutes the drive would fill up and you would have to pause the surgery and burn a DVD. Not a good situation.

Ok, so you can edit MPEG1, no problem. However MPEG1’s official spec is 352x240, VideoCD quality. Sure you can uprez this to DV, but at a loss. Even when you get MPEG2, it is often 640x480 and needs to be scaled.

Therefore, regardless of what format the OR is capable of recording, your best friend is a portable DV deck, such as the ubiquitous Sony clamshell that they even use on the space station. A home video camera with an S-Video input will do the job, but these cameras wear out quickly if you use them a lot. From 1999 to about 2003 we traveled with a desktop DVCPRO recorder. Newer digital recording devices came to market in 2008, offering XDCAM and JPEG2000 recording. The future is looking bright!

During laparoscopy much of the imaging is out of our control, so here is a good checklist to help you advise the surgeons.

• Make sure the mounted laparoscopic camera is white balanced.

• Check the OR monitors with bars. Usually the OR CCU generates bars when first powered up.

• Keep an eye on the focus and clarity of the laparoscopic camera. Due to the temperature difference between the OR and the inside of a person, it is common for the lens to fog up, just like when you drive your car on a muggy day. Also, interns or less experienced residents are often driving the camera, and they need to be reminded to keep things in focus and to follow the action.

• It's not unusual to have establishing shots outside the patient. Many surgeons like to work with the lights down. It's easier for them to focus, and if you light it right, it can look really cool. Try to point one OR light or a low wattage video light at the ceiling, just to get enough fill to avoid having to use too much gain.

Finally, watch for smeared blood on the lens. Need I say more?


Some Other Tricks To Keep In Your Back Pocket

This headline is especially appropriate, because when you are wearing medical scrubs, you need to shove your wallet, keys, phone and some spare DV tapes in your lone back pocket. Be careful if you sit down. What am I saying, you won’t be sitting down!

Some operating rooms give you a Tyvek “bunny suit,” which labels you as an outsider, but at least you have your own pockets!

Let’s say you are shooting an open operation, and no matter how you position the camera, you can’t see what’s going on. In some cases, the surgeons can’t see what they are doing either, but they can feel what they need to. Laparoscope to the rescue. Sometimes if you ask nicely, the circulating nurse will fetch a laparoscope and video tower. One of the surgeons or assistants can get this sterile camera deep down inside the body to get the shot that your overhead camera will never see. Some surgeons have had success shooting surgery with a laparoscopic camera head mounted to a rigid instrument clamp, without the optical scope.

That being said, never try to shoot a whole operation using a hand-held laparoscope, a head mounted camera or a camera built into an OR light. Sometimes this is exactly what you get. With some clever editing, this material can be made to work, but it is not optimal, and it looks like video shot with a handheld laparoscope or head mounted camera. The overhead light mounted camera can be okay, however the exposure tends to be hot and the zoom tends to be not used.

 

Fixing it in Post

The first step is of course capturing your raw footage. Back in the day, we would log each tape into an EDL then auto assemble edit the first cut onto 1”. Subsequent edits were made to the EDL itself (3.5” floppy) then another auto assemble to another reel of tape, or insert edit over the for edit. However we tended to keep every edit for reference.

Today of course we just capture the tapes in their entirety into Premiere Pro. While tapes are being gobbled up, we can work on another project on another computer. Each of our three editors has at least two computers side by side so we never get bored!

The first cut requires watching the raw footage in real time. As you view, you cut out the dead space, the repetition and anything that makes the surgeon look sloppy. That is, my job is not only to edit for content, but also to make the surgeon look awesome.

Years ago, a video on hernia repair featured one shot of a dull pair of scissors trying to cut a suture. I couldn't understand why, but edit after edit, the surgeon insisted on leaving this shot in.

Hernia surgery is wildly popular, so when it came time to show the video, the house was packed. When we came to the part I was worried about, the narrator said, “…and the suture is cut with a sharp pair of scissors.”

The crowd went crazy!

Apparently dull instruments are a common pet peeve of surgeons, and presumably of their patients.

While I do not spend a lot of time talking about technology, knowing what you have and how to use it can make or break a project.

A video on the sterile environment in the OR was nearly complete. However one of the reviewers noticed that we show a contaminated item being deposited into a red medical waste bag. In reality, a contaminated item not soiled with blood can be placed in a blue, non-contaminated bag. (Note positions of colored bags, below.)

Operating room - note positions of blue and red bags

 

What to do? Boris FX luckily allowed me to isolate the red bag’s color range and change it to a suitable blue. Luckily the shot is only a few seconds, but it did the trick. As it turned out, there were a few other bag shots which needed to be changed. Thankfully there were no blue bags needing to turn red, because in an OR, everything is blue!

Another video I worked on, this one about electrosurgery, discusses the use of smoke evacuation. During the use of the electrosurgery pencil, surgical smoke plume, depending upon the wattage, can be plentiful and hazardous.

During our shoot we got a few shots showing the proper use of a smoke evacuation unit. However some other nice stock footage shot elsewhere showed just the use of electrosurgery being discussed, but no smoke evacuator. However, a screen grab of the correct tool from another shot, a quick visit to Photoshop to erase the background, and voila, the shot now has a smoke evacuator. A keyframe animation in Premiere and 20% reduction in opacity and it just might work.

Again, if the shot is only a few seconds, and you don’t call attention to the effect, it can be “effect”-ive. Clever huh?

 

War Stories

Back in the mid-90’s, Ciné-Med was a leader in Virtual Reality surgical training. Thanks in part to a grant from DARPA, the same folks who brought us the Internet, and some generous sponsors, we had a traveling exhibit.

In 1995 if you wanted a 3D graphic, you used a SGI box, such as the Crimson Reality Engine. These early RISC based processors were the bee’s knees for graphics, and weighed. One simulator in particular, and the most popular E-Ticket ride, was the Virtual Journey through the Heart. The user wore a head mounted display and held a joystick. The joystick beat in sync with the sound of the heart, and the visually beating heart seen in the HMD. If you turned your head or looked up or down, magnetic sensors called Flock of Birds told the computer which way to move the heart model. The joystick allowed you to fly into the vena cava and through the atria and ventricles.

Who wouldn’t want to experience the thrill of flying through the mitral valve or rounding the bend past the tricuspid valve? How exciting!

The only problem was, nearly every time we took this thing on the road, something malfunctioned. I should add that in 1995, most people did not have cell phones. One particular experience was at the Atlanta convention center. We setup our exhibit, threw the switch, and nothing happened. I found a pay phone, talked to the programmer, wrote down some UNIX commands, went back to the exhibit, and repeated this sequence until things began to work again. Those were the days indeed. These days when you see a VR surgical trainer, it runs off a laptop!

Skull

Surgeons reach a patient's skull.

One final story kids, then it’s off to bed. Live surgery is quite popular. Many hospital websites feature live and recorded webcasts of new procedures, intended to interest the general public is asking for those procedures when they need them, at that hospital. However certain medical conventions have banned live surgery broadcasts due to liability concerns (the “oh crud” factor).

So one year we devised a live-on-tape surgery session. Four surgeons recorded their procedures ahead of time and sent us the raw footage of both the laparoscopic inside view, and the outside overhead view. It was our job to edit the four cases down to about one hour each, but to do it in a way that did not look too “edited.” Let’s call it “minimally edited.”

This was back in 2000 using a Media 100 XR with 1 real time video track. The only way to keep the edit in sync was to edit everything on one timeline, make the cuts, then when ready, make a 2nd timeline for the 2nd view. Then we made a DVCPRO master for both timelines, and repeated this for all the cases.

When it was time for the main event, we flew to Chicago, took our two portable DVCPRO machines with us, wired them up to two projectors and manually synced the tapes to play in as close to synchronization as possible.

One problem, when we got to Chicago, I reviewed the tapes with the moderator of the session. One of the four procedures was unacceptable, edited too tightly, and there was not enough outside footage to match the inside.

“Don’t you have the raw footage with you?”

“No, that’s crazy talk.” I replied. This was 5pm the night before the event. I rushed to the airport, got on a 6pm flight back to Hartford, drove back to the office, digitized the missing footage, managed to have no technical glitches, and began making my two non-simultaneous DVCPRO masters at midnight. The masters were done around 3am. My return flight at 8am allowed me 2 hours time to sleep on the floor of my edit suite (not very restful).

I got back to the airport and was told I would have to go standby. With no guarantee that I would get to Chicago at all, I drove over to the airline’s freight office and checked my tapes as cargo, then went back to the airport and actually got on the flight. Only problem there is once I got to Chicago I had to wait at the freight counter for my cargo to be checked in, which apparently is considered non-urgent.

With package in hand a cab ride took me to the convention center. McCormick place for those who don’t know is slightly smaller than the Pentagon, so it was quite a walk. I arrived at 10:30am, with 20 minutes to spare before the tapes were needed. Mission accomplished. Oh wait, I needed to shower, shave and spend the rest of the day working the booth.

 

Clear view of the surgeryA crystal-clear view of surgery in progress

 

Summary

I have tried in this article to discuss the craft of medical/surgical video, and shed some light on how Ciné-Med has made this into a business. It is also an adventure. Every day is different and I look forward to every project, and to helping surgeons become better surgeons.

As we interface with in-hospital media services, we have learned to adapt to each situation, to think on our feet and to keep in mind the ultimate goal: capturing the best images possible. Indeed, the techniques and tricks of the trade valuable to surgical video are quite similar to broadcast production.

There are many ways to approach a situation, none of them wrong. Sharing knowledge is the key. We can learn from surgeons and their in-house resources, and they can learn from us. I enjoy knowing that we're helping doctors become better surgeons.

 


 

Mike Cohen, Cine-Med medical and surgical video and education

Michael Cohen is a charter member of the Cow, joining on its very first day. He's a specialist in Medical/Surgical video production, multimedia-based education, and project management for Cine-Med.. One of the hosts of the Business & Marketing forum, you can also find him in forums including Art of the Edit, Audio Professional, Broadcast Design, Compression Techniques, Flash and Premiere Pro. As Mike says, “Tools and technology are good to know, but craft and know-how pay the bills.”

And be sure to check out Mike's Creative Cow blog.



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Comments

Re: Surgical Video: The Cutting Edge
by Mike Cohen
This thread may be useful should anyone find themselves facing a medical video shoot in their immediate future.
http://forums.creativecow.net/readpost/313/824

Mike
Re: Surgical Video: The Cutting Edge
by accem scott
Great article Mike.
I am wondering how I might enter into the field of surgical videography. I have background in the medical field as a surgical tech. What would be my approach to finding jobs in this field. I live in Asheville, NC
Re: Surgical Video: The Cutting Edge
by accem scott
Great article Mike.
I am wondering how I might enter into the field of surgical videography. I have background in the medical field as a surgical tech. What would be my approach to finding jobs in this field. I live in Asheville, NC
Re: Surgical Video: The Cutting Edge
by Jeff Turpin
Mike,

Thanks for the post. I am an orthopedic distributor in North Carolina. I am in need of some technical assistance in taking quality video and photos in the OR. Would you or anyone you know be interested in helping? My phone number is 919-807-1248.
Re: Surgical Video: The Cutting Edge
by Mike Cohen
I continue to receive e-mails related to this article. Thanks for the continued interest. Please post messages here if your comment is a plea for help! There are others who may also be able to help.

Mike Cohen
more info
by Mike Cohen
I thought I'd direct those interested to our listing on the COW's services directory:

http://services.creativecow.net/s/552/cine-med

Thanks for your continued interest in this article.
video sample
by gyungnam kim
Dear Mike

I really liked your video sample which is the one of the best surgial videos I have seen before.
It is possible for us to have it so that I can use for our product demonstarion. We are selling surgical displays. you may visit our website for more information. I appreiate your kind help.

Best Regards

Steve Kim
General Manager
WIDE EU OFFICE
Hullenbergweg 413
1101 CS Amsterdam Zuidoost, The Netherlands
http://www.widecorp.com
Tel: +31-20-311-9797
Fax: +31-20-311-9790
Mobile: +31-6-2851-5800
E-mail: steve@widecorp.com
Surgical Video: The Cutting Edge
by Joe Ritland
I am at The University of Iowa (Hospitals and Clinics) in Iowa City, IA. We don't do a ton of OR shooting, but seem to be doing more lately. It was great to get your take on that stuff. I really like doing it. So far, we've done mostly tripod or handheld shooting, which as you well know, doesn't always get the shot you need and can burn your arms up in the process. We really need a rig like you pictured in the story, and it's nice to see that it can be done at a reasonable cost. Thanks for your info. If you ever want to talk shop, I'm at: joseph-ritland@uiowa.edu
Surgical Video: The Cutting Edge
by Mike Cohen
Joe, try the various magic arms by Bogen. They use them on the Space Station to hold laptops, so they must be safe for the OR.
A few surgeons have expressed safety concerns, but I tend to have my hands on or near the camera at all times.
Where do you work, if you don't mind saying?
Mike
Surgical Video: The Cutting Edge
by Joe Ritland
Great stuff Mike. Thanks. I am an "in-house" guy at a teaching hospital. I was hoping you could tell me what you have attached to the top of the baby roller stand in the picture (with the black arm holding the camera over the surgery field). Is it a problem keeping a camera secure on there? Thanks.

Joe
Surgical Video: The Cutting Edge
by Mike Cohen
depends what you are shooting - be ready for anything
Surgical Video: The Cutting Edge
by Al Davis
Joe (and Mike), having used a well-placed tripod, and hand-held combo; I still feel that the hand-held (as uncomfortable as it may be)still gets me the "money shot". I so much enjoy doing this work; and that is what I feel is my greatest asset - listening to the surgeon, and using it as my key to determine my shot. A mounted camera just doesn't quite get me there. They are however GREAT for cutaways when you get an elbow in your lens, or a shoulder blocking you.
Surgical Video: The Cutting Edge
by Mike Cohen
blush!

Thanks Ron for the compliments, and for running the best website on the internet. I am a little addicted!

Mike
Surgical Video: The Cutting Edge
by Ron Lindeboom
Mike,

It is quite remarkable just reading the comments to this article. The article was an honor to have in Creative COW Magazine and the online expanded edition is even better. But reading the comments from the bottom ones to the newest ones at the top, I have to tip the hat to you for being easily one of the most fascinating reads in all the years we have been building forums and hosting articles.

Thanks for being a part of the COW, Mike.
Surgical Video: The Cutting Edge
by Quddus Miller

You cannot believe how excited I was when I saw the article in the
creative cow magazine. I got even more excited when I read the article
about what you do. I am a professional videographer. I have been in the
business for 14 years. I can of course do it all, edit, shoot, mix
audio; a little bit of engineering, a little bit of web
casting/streaming,etc. Just over a year ago I had to have major surgery.
I became very interested in having my own surgery filmed so I could make
a documentary out of it. I did this with out knowing that people
actually do this for a business. How did you get into this business
originally? How did you make the connections with the medical companies
and surgens, medical institutions who would be interested in buying the
documentaries ? Did you hook up with a particular doctor or medical
institution ? How did you get the ball rolling ?
Surgical Video: The Cutting Edge
by Mike Cohen
in response to the most recent comment - thanks for the feedback. It is beyond the scope of this article to tell you how to start a business - check out other areas of the COW for that

http://library.creativecow.net/tutorials/businessmarketing

Cine-Med has been around for 30 years.
Surgical Video: The Cutting Edge
by Mike Cohen
Ed
We have used a variety of setups over the years, depending upon the surgery. Have shot with a huge Jimmy Jib or various versions of the baby roller stand with something to hold the camera. We visited B+H and found a few things to try out. Sometimes regular sticks will suffice, hand held, shoulder mount can also work for some situations.

Like most production, you need to be ready for anything.
Surgical Video: The Cutting Edge
by Ed Tworek
What's the camera rig you are using? Looks like a Matthews roller stand with something like a jib arm.
Surgical Video: The Cutting Edge
by Mike Cohen
for those interested, here is an example of HDV as a still frame taken from Premiere.
http://i1.creativecow.net/u/81/fallopianhd2.jpg
Surgical Video: The Cutting Edge
by Kelly Johnson
We do a lot of our spine cases with endoscopes and even in some crani cases. We are currently looking to upgrade both our endoscopic systems and microscope systems with HD cameras. I am pretty stoked to take this next step.

Mike- I am planning on being at the meeting. A bonus is that I live about an hour away from Park City.
Surgical Video: The Cutting Edge
by Paul Jackson
Kelly, I seldom see a surgical edit without laparoscopic cameras. I've been fortunate that most of the med centers in this area are teaching hospitals and have fairly sophisticated laparo systems, most often high-end optics connected to 3-chip camera heads, recorded to DigiBeta or DVCPro50. The detail on these scenes will blow you away.
Surgical Video: The Cutting Edge
by Mike Cohen
Kelly - Microscopes can produce a gamut of images, from stunning to disappointing. As I said in the article, I can learn from folks like you - ScopeBox is a new one for me, I will have to check it out.
There are in-house media departments in a lot of larger hospitals, some do some great work. Keep in touch.
Mike

PS - The Biocommunications Association annual meeting is in Park City this year. Are you going?
Surgical Video: The Cutting Edge
by Kelly Johnson
Mike,
That was a fun article to read. I am what you referred to in your article as an in-house person. I photograph and film cases for neurosurgery and find it both fulfilling and fascinating. It is interesting to note that 80% of the cases I am filming are done using a surgical microscope so the camera I use is strapped onto the microscope. I capture all of my video directly to my laptop using ScopeBox. It was great to see this article because some times I think I am the only one doing this kind of stuff.
Surgical Video: The Cutting Edge
by Steve Nordhauser
Congratulations! First on some groundbreaking work and second on getting through the entire article without using the phrase 'bleeding edge'.
Surgical Video: The Cutting Edge
by david lincoln brooks
Wow, Mike... Is THAT what I have inside of me?? And I thought it was all sunshine, lollipops and rainbows.

Seriously, those are some amazing photos. Kudos to you!

DAVE
Surgical Video: The Cutting Edge
by Ed Tworek
What a timely email from the COW. I'm shooting my third surgery Friday, a rhinoplasty. So far the video from the previous two surgeries has been great. Now, thanks to the shooting tips in this tutorial, I can provide my client with even better video. Any tips for shooting plastic surgery? That seems to be the direction I'm headed.
Surgical Video: The Cutting Edge
by Mike Cohen
Thanks for the nice comments. It is always nice to see favorable comments from colleagues as well as medical folks. While not mentioned in the article, it is helpful to have something resembling an understanding of what you are looking at. Knowing the difference between a Pancreaticoduodenectomy and a Pancreaticojejunostomy is just one example.
Incidentally, I do all of the temporary voice overs for our videos, so I have learned to say this stuff, as well as spell it. Happy New Year.
Surgical Video: The Cutting Edge
by Tim Wilson
Amazing stuff, Mike. Wonderful to read about the combination of technical problem-solving and people management skills. FANTASTIC pictures! I really enjoy your Cow blog too. Keep up the great work!
Surgical Video: The Cutting Edge
by Carl Stewart
I was a surgical nurse in the U.S. Air Force (1979-84), and I've wanted to do surgical video work ever since, but I've never been able to crack that nut. Any suggestions would be appreciated.
Surgical Video: The Cutting Edge
by Mike Cohen
Ed - good communication with the surgeon is essential. Plastic surgery videos can be a challenge because often the working area is so small, that if you zoom in too tight you can lose track of what you are looking at. Remember to zoom out once in a while to stay oriented.
As with a lot of surgery, if the lights are focused in on a small area, a wide shot will have a bright center surrounded by darkness. A Rifa light or Chimera might help with the contrast problems, however I am reluctant to plug a video light into an OR during surgery for obvious reasons. Always get clinical engineering's approval before plugging anything in.
Surgical Video: The Cutting Edge
by Steve Wargo
Great Photos!!!!
We've done some surgical proceedures but nothing of this magnitude. Very nice.
Surgical Video: The Cutting Edge
by Paul Jackson
Good stuff! I've done quite a bit of surgical cutting (pun intended) and the edit suite has proven to been a stress-relief venue for high-ranked surgeons. Eating pizza, drinking beer and cracking jokes about the kidney surgery happening on the screen can get these guys to really lay back, especially when the client is a big medical supply company and you're promoting their high-tech surgical equipment...more pizza & beer.

I've caught the good doctors' mistakes and offered post-fixes, which sometimes have led to private-release edits of comically botched surgery ("don't try this at home"). Not to mention, one can usually get some free med advice...
Surgical Video: The Cutting Edge
by Al Davis
Terrific article Mike. I have done several breast reconstruction surgeries, as well as many hernia procedures. I agree with all your major points. The new wave of tape-less cameras are going to have a huge impact on how we can cover lengthy surgeries with multiple cameras. Just a small chip in your back pocket will do it now!!!
Surgical Video: The Cutting Edge
by Cade Muhlig
yuck!


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More Than One Path to Success: Senior Editor Mae Manning

More Than One Path to Success: Senior Editor Mae Manning

We talk a lot about things like “accessible tools” and the “democratization of video production” -- what has this meant for the emerging talent whose creative development has taken place largely, or even entirely, within this democratized landscape? Mae Manning is one such editor, who taught herself to edit music videos, and caught the eye of a local production company. Several years later and now their Senior Editor, she cuts corporate and industrial training videos, promotional videos, sketch comedy, short films, and everything else that gets thrown her way. Mae’s story is an inspiration for anyone that thinks there is only one path to success in the industry.

Feature
Kylee Peña
Art of the Edit
How To Create Better Live Surgical Broadcasts

How To Create Better Live Surgical Broadcasts

Greg Ondera produces, directs, and edits medical video programs specializing in surgical procedures. From his wide ranging experience in the medical sciences and broadcast arts, Greg shows you how to create better surgical broadcasts.

Editorial, Tutorial, Feature, Business
Greg Ondera
Art of the Edit
Being an Advertising Editor: The Ins & Outs of Agency Work

Being an Advertising Editor: The Ins & Outs of Agency Work

Katie Toomey takes Creative COW members inside the world of the advertising editor, where being a generalist means you are often not only a video editor, but a designer and audio editor, problem solver, as well as tech support professional. Join Katie as she takes you inside her world.

Editorial, Feature, People / Interview
Katie Toomey
Art of the Edit
The Science of Editing

The Science of Editing

Sven Pape, aka @ThisGuyEdits, joins Dr. Karen Pearlman -- former President of the Australian Screen Editors Guild and a three-time nominee for Best Editing at the Australian Screen Editors Guild Annual Awards -- for a provocative look at "Editor's Thinking," a cognitive skill set that you can use to improve your screenplay before you start principal photography of your film.


Sven Pape
Art of the Edit
Film Editing Tutorial: How To Crush The First Notes

Film Editing Tutorial: How To Crush The First Notes

It's happened to you. The first cut sounds noisy, has compression artifacts, actors aren't giving their best performances -- and the director has notes about all this and more. Follow along as Sven Pape from "This Guy Edits" works through some of these very issues on the film he's working on, with tips on how deliver exactly what YOUR director is looking for.

Tutorial
Sven Pape
Art of the Edit
Editing Movie Trailers with Patricio Hoter

Editing Movie Trailers with Patricio Hoter

More and more, films that are currently in production are working alongside with their marketing teams to establish a strategy months in advance of its release. That means that there’s more time to explore several options when crafting a trailer, but the workload also becomes heavier, and the stakes become higher. Avid Media Composer editors Christian Jhonson and Patricio Hoter (The Jungle Book, The Last Witch Hunter, Green Room, Titanic 3D, and more) explore this evolving artform.

Tutorial
Christian Jhonson
Art of the Edit
5 Tips for Finding the Right Edit Point

5 Tips for Finding the Right Edit Point

Accomplished editors tend to point to instinct and experience when it comes to the exact edit point. Here are 5 tips from veteran editor Sven Pape of "This Guy Edits" that may help you get there. Some editors say that great editing is invisible. So is the right frame the one we don't notice?

Tutorial
Sven Pape
Art of the Edit
The Surprising Upside Of Procrastination In Film Editing

The Surprising Upside Of Procrastination In Film Editing

What if you wouldn't have to stop procrastinating? Sven Pape of "This Guy Edits" demonstrates how to use procrastination to achieve some of your best film editing work. "Why do I procrastinate?" asks Sven, "I give you Aaron Sorkin who has one of the best procrastination quotes: "You call it procrastination I call it thinking.""

Tutorial
Sven Pape
Art of the Edit
The Secret World of Foley, One of Cinema's Most Magical Arts

The Secret World of Foley, One of Cinema's Most Magical Arts

The Secret World of Foley is an evocative, wordless insight into one of the cinema’s most magical arts: the creative addition of synchronized sound effects in post known as Foley. This short film is also one of the most beautiful things you've seen in a long time. We highly recommend it to any fans of movies, sound, and the inspiration of watching true artists at work.

Feature
Tim Wilson
Art of the Edit
FuseFX & mocha: VFX for Walking Dead, Empire, AHS & More

FuseFX & mocha: VFX for Walking Dead, Empire, AHS & More

The 100+ member team at FuseFX juggles over 30 television episodics a season, while also working on features and commercials. Current credits include: FOX's Empire, ABC's Agents of SHIELD, AMC's The Walking Dead, SyFy's The Magicians, CBS's Zoo, and FX's American Horror Story. Brigitte Bourque, FuseFX's Digital Effects Supervisor and a 20 year industry vet, talks to us about the work that FuseFX does, and how Imagineer Systems mocha fits into their pipeline.

Feature, People / Interview
Imagineer Systems
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