Choosing a topic is just the beginning

For residents, surgical technique videos can help bridge the gap between classroom instruction and clinical application. They also serve as important learning tools for physicians, surgeons, and allied healthcare personnel.

But although anyone can make a video these days—especially with the handheld technology available—video recording a surgical technique for educational purposes requires more than just a camera in the operating room. To find out what’s involved in creating an orthopaedic surgical video that demonstrates current concepts in surgical treatments and provides relevant instructional content, AAOS Now spoke with Anand M. Murthi, MD, shoulder and elbow section editor of Orthopaedic Knowledge Online (OKO). Dr. Murthi is the author of two OKO surgical videos: “Arthroscopic Transosseous Equivalent Double-Row Rotator Cuff Repair” and “Arthroscopic Capsular Release of the Glenohumeral Joint.”

Make it clear
“A good surgical video must be easy to follow and easy to listen to. It must provide fundamental goals for the audience. It should also include excellent video production techniques and incorporate multiple viewing angles so that viewers feel as though they are in the operating room,” explained Dr. Murthi.

“OKO surgical videos also provide our viewers with the why—the indications for a particular surgery,” he added. “Our authors spend a tremendous amount of time creating these online modules. And unlike other online video education sites, OKO is the only peer-reviewed site that provides educational orthopaedic modules.”

Dr. Murthi says he chooses topics for surgical videos based on discussions with peers and colleagues about new surgical procedures and discoveries in the field. During these discussions, he also searches out qualified authors to contribute their time and talents. Once a topic is chosen and an author selected, production begins.

“Logistically speaking, producing a surgical video is challenging. First, we must have the right patient—one who has the right pathology and who also consents to having the procedure recorded for educational purposes. Then, we have to coordinate with a video production team,” said Dr. Murthi.

The potential for things to go wrong during filming is substantial: the surgery may be canceled, technical difficulties may arise, the recording quality may be poor, or an intraoperative complication may occur. In some cases, says Dr. Murthi, although a surgery goes perfectly, it just isn’t aesthetically pleasing for video. It is very important to keep your head out of the way and to control bleeding around the surgical site to ensure an excellent view of the operative field.

He believes a good surgical video should use high-quality camera work and excellent video effects, such as dual views—for example, a view from outside of the shoulder combined with an inside view from the arthroscope. Dr. Murthi also prefers providing live commentary during the video rather than using a recorded voiceover, which can be very difficult to synchronize to the video. Videos with poor voiceovers or poor discussion of the surgery by the surgeon during taping are much less effective, he says.

OKO currently has more than 250 surgical video clips and full-length videos, including some that offer CME credit, available for AAOS member and subscriber viewing. For more information, visit www.aaos.org/oko

For more information on video production techniques, check the Annual Meeting Call for Participation, which includes tips and peer review guidelines that can help you produce a top-quality video.

Disclosure information: Dr. Murthi—Zimmer; Ascension; Current Orthopaedic Practice

Maureen Leahy is assistant managing editor of AAOS Now. She can be reached at leahy@aaos.org

The dos and don’ts for creating a surgical video

Do:

• Work with an experienced professional video production team that uses multiple cameras for production from multiple angles and ask to view samples of their work. Be sure the team knows how to incorporate graphics and text, when to use special effects to enhance the educational program, and how to do high-performance editing.
• Choose the right patient. Make sure the patient has consented to the surgery and that the pathology is straightforward and simple. The patient must also consent to the taping of the surgery and know how the tape will be used. Use a legal consent form for authorization.
• Plan ahead. When scheduling the video production, be sure to consult with your assistant and the operating room staff regarding their availability and your plans. Make sure all your surgical equipment is available and have backups if necessary—there are no second takes during surgery.
• Develop an outline of the procedure for the video production team. Provide an explanation for each step in the procedure and note your important teaching points. Identify comments you might make in your narration about managing surgical complications or pitfalls, as well as possible outcomes.
• Outline the commentary you will provide during the surgery or have it nearby on a cheat sheet that you can refer to off camera. It’s important not to omit any critical information—once again, there are no second takes.

Don’t:

• Make your taping the last case of a long day.
• Schedule a complex revision surgery if the video is about a simple straightforward procedure.
• Ad lib the commentary.
• Use slang or vocalized pauses in the commentary.