Recording and editing cases

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SLUser11

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Hi,

For the practicing laparoscopic surgeons out there, I am trying to record a lot of my cases in order to use them for resident education, etc. I am taping everything from lap colectomies to TAMIS to Robot LARs/APRs. The problem is that the discs I'm given by the OR have HUGE files (multiple mpgs, 12 minutes each, 350mb), probably because the videos are in high definition.

I was hoping to get some advice/suggestions regarding:

-Editing and combining videos
-shortening videos
-Converting to a smaller file size
-Adding sound/voice-over

What video editing program do you guys recommend? I would want the program to be simultaneously affordable and idiot-proof if possible.

Thanks in advance for your help.
 
Surely your hospital has a media or IT person that can help you with these questions?
If not, our equivalent of what you want is here:
http://www.sinusvideos.com/
You could touch base with them via e mail and see if they have any suggestions. I have contacted them in the past about things and they are very responsive.
 
I would call the local Trial Bar and ask them what kind of editing their members would prefer. They will want to present a well produced video to the jury during your malpractice trial.
 
Pir8DeacDoc said:
Surely your hospital has a media or IT person that can help you with these questions?
If not, our equivalent of what you want is here:
http://www.sinusvideos.com/
You could touch base with them via e mail and see if they have any suggestions. I have contacted them in the past about things and they are very responsive.
Click to expand...

There are IT people who can sort-of help, but I was wanting input from someone with a similar background and similar goals. The programs they have may not be the best ones for clinical work, etc.

I'll have a look at that website. Thanks.

Fah-Q said:
I would call the local Trial Bar and ask them what kind of editing their members would prefer. They will want to present a well produced video to the jury during your malpractice trial.
Click to expand...

I know you're being facetious, but are you seriously afraid to record your surgeries?
 
SLUser11 said:
For the practicing laparoscopic surgeons out there, I am trying to record a lot of my cases in order to use them for resident education, etc. I am taping everything from lap colectomies to TAMIS to Robot LARs/APRs. The problem is that the discs I'm given by the OR have HUGE files (multiple mpgs, 12 minutes each, 350mb), probably because the videos are in high definition.
Click to expand...
Those file sizes are actually pretty reasonable given that they're HD. An hour of uncompressed video can easily be 2-4GB.

I was hoping to get some advice/suggestions regarding:

-Editing and combining videos
-shortening videos
-Converting to a smaller file size
-Adding sound/voice-over

What video editing program do you guys recommend? I would want the program to be simultaneously affordable and idiot-proof if possible.
Click to expand...
I have a freeware MPG trimmer that can simply trim and combine videos for you, but I can't find a link to it just now. If you want something very, very simple, I'll look it up for you.

If you want to create a nice, finished product, I've used Pinnacle video editors before, and it was very intuitive. It could do DVD authoring, DVD menus/chapters, captions, voice-over, music, transitions, etc. When you render the video, you can compress it as well. I haven't used any of their latest editions, but I was actually thinking of getting it - http://www.pinnaclesys.com/PublicSite/us/Home/

I would strongly recommend using a powerful computer with a lot of storage to do this (and make sure you videos are stripped of PHI before you keep them on your home PC). If you want detailed recommendations, you can message me.

Also, if you want to distribute these videos to residents/staff, you can put them on your Google Drive and people can watch them online (like YouTube), or they can download them. You have absolute authority over who has access to the videos, and the first 5GB is free, and 200GB is $10/month. It is much easier than burning a stack of DVDs and handing them out.
 
SLUser11 said:
I know you're being facetious, but are you seriously afraid to record your surgeries?
Click to expand...

Yes, and you should be too. You have to realize that there are an untold number of people out there whose job is to sue you. Trial lawyers and their physician expert ****** would love nothing else than to have video documentation of your "malpractice." They will show the jury the video of your anastomosis and the "expert" will explain how you did it all wrong and that is why the patient had a leak. This is not a novel concept. Plenty of physicians have been sued using their video as evidence against them.

You need to disclose to your malpractice carrier that you are creating videos and get an opinion and/or rider from them. The last thing you want to happen is to not tell them you are doing this and then get sued. If they discover your activity after a suit has been filed they might decide that your policy does not cover your actions and then you are bare-arsed for the lawyer sodomites to attack.

You go to sleep at night thinking about how to be a better surgeon and teacher and these videos will serve that purpose. A trial lawyer goes to sleep at night thinking about how to successfully sue you and these videos will serve that purpose.
 
Not sure if its because I had to many bourbons at the office Christmas party, or I'm just a dumb heart surgeon now..... But SLU what is a TAMIS?
 
ESU_MD said:
Not sure if its because I had to many bourbons at the office Christmas party, or I'm just a dumb heart surgeon now..... But SLU what is a TAMIS?
Click to expand...

TAMIS --> Trans-anal Miminally Invasive Surgery (which sounds good because if anything's coming near my anus, I'd rather it be minimally invasive as well :laugh: )
 
ESU_MD said:
Not sure if its because I had to many bourbons at the office Christmas party, or I'm just a dumb heart surgeon now..... But SLU what is a TAMIS?
Click to expand...

It's basically TEMS (Transanal endoscopic microsurgery) using a single-port device and conventional laparoscopic instruments. There have been many acronyms suggested, of which my favorite is ASSPAS (anal surgery single port access system).

It allows for me to do a nicer transanal excision with a lower chance of positive margins, and it allows me to excise lesions higher up (2-15cm) in the rectum, so it often spares the patient a low anterior resection or APR. I do it for all non-cancerous polyps, and for the favorable T1 cancers in a well-informed patient, or even T2-T3 cancers for patients who cannot tolerate invasive surgery.

Fah-Q said:
Yes, and you should be too. You have to realize that there are an untold number of people out there whose job is to sue you. Trial lawyers and their physician expert ****** would love nothing else than to have video documentation of your "malpractice." They will show the jury the video of your anastomosis and the "expert" will explain how you did it all wrong and that is why the patient had a leak. This is not a novel concept. Plenty of physicians have been sued using their video as evidence against them.

You need to disclose to your malpractice carrier that you are creating videos and get an opinion and/or rider from them. The last thing you want to happen is to not tell them you are doing this and then get sued. If they discover your activity after a suit has been filed they might decide that your policy does not cover your actions and then you are bare-arsed for the lawyer sodomites to attack.

You go to sleep at night thinking about how to be a better surgeon and teacher and these videos will serve that purpose. A trial lawyer goes to sleep at night thinking about how to successfully sue you and these videos will serve that purpose.
Click to expand...

I understand your point, but I'm going to keep recording my cases. If we all collapsed due to fear of litigation, there would be no surgical videos at all, and progress would slow trememdously.

My malpractice carrier already knows about this. My division frequently presents videos at SAGES, etc.

Of course, all patient identifying factors are removed from the videos to maintain their privacy.
 
SLUser11 said:
I understand your point, but I'm going to keep recording my cases. If we all collapsed due to fear of litigation, there would be no surgical videos at all, and progress would slow trememdously.

My malpractice carrier already knows about this. My division frequently presents videos at SAGES, etc.

Of course, all patient identifying factors are removed from the videos to maintain their privacy.
Click to expand...

Very good. Never let your guard down.
 
Fah-Q said:
You need to disclose to your malpractice carrier that you are creating videos and get an opinion and/or rider from them. The last thing you want to happen is to not tell them you are doing this and then get sued. If they discover your activity after a suit has been filed they might decide that your policy does not cover your actions and then you are bare-arsed for the lawyer sodomites to attack.
Click to expand...
Great point.

If all of his videos were stripped of protected health information as soon as (or before) he received them, including the date of the procedure, then I think that would definitely add a layer of protection. "Oh, the anastomosis that leaked? I have no idea which video that was..." Not to mention that you're not supposed to keep PHI anyway.

I went to a conference this year that showed all kinds of horrible things that occurred on video - transected ureter after transected ureter - and somebody felt comfortable saving these and then showing them to a thousand surgeons in a room.

SLUser11 said:
My malpractice carrier already knows about this. My division frequently presents videos at SAGES, etc.

Of course, all patient identifying factors are removed from the videos to maintain their privacy.
Click to expand...
Did your insurance carrier have any comments/insight?
 
I remember watching TEMs and wondering how a patient can remain continent after having that scope placed! I have to imagine thats a risk you prepare pts for preop during consent
 
ESU_MD said:
I remember watching TEMs and wondering how a patient can remain continent after having that scope placed! I have to imagine thats a risk you prepare pts for preop during consent
Click to expand...
Just picture a baby's head going through the vagina...
 
TheProwler said:
I went to a conference this year that showed all kinds of horrible things that occurred on video - transected ureter after transected ureter - and somebody felt comfortable saving these and then showing them to a thousand surgeons in a room.
Click to expand...

I believe the title of that symposium was, "Nightmare at the Movies," and certainly it took courage to present those complications. I'm just as certain that this courage greatly benefited the audience.

My insurance had no specific insight.

ESU_MD said:
I remember watching TEMs and wondering how a patient can remain continent after having that scope placed! I have to imagine thats a risk you prepare pts for preop during consent
Click to expand...

I will say that the TAMIS device is a little less intimidating, but the diameter of the TEMS silver proctoscope is 40mm. Surprisingly, the rate of incontinence is less than 5%, which is equal or lower than the published rate for most anorectal surgeries.
 
I've been dabbling with Windows Movie Maker a bit this week, and it's better than my first impression. Given what you're probably looking to do, it's probably more than adequate for video editing. It's quite easy to trim clips, rearrange them, narrate, put captions or title pages or credits in, do transitions, etc. I think you can also play clips at increased speeds with Yakety Sax in the background if you want. Then you can render them to different files or burn them to a DVD.
 
FaytlND said:
You know what they say about a proctoscope...

There's an a$!h0le at both ends.
Click to expand...

I do know what they say.

TheProwler said:
I've been dabbling with Windows Movie Maker a bit this week, and it's better than my first impression. Given what you're probably looking to do, it's probably more than adequate for video editing. It's quite easy to trim clips, rearrange them, narrate, put captions or title pages or credits in, do transitions, etc. I think you can also play clips at increased speeds with Yakety Sax in the background if you want. Then you can render them to different files or burn them to a DVD.
Click to expand...

Thanks. I'm going to start with Movie Maker and see how far I get.
 
The last time I did this sort of thing I used quicktime pro. Paid for the license. Used it because it was the cheapest that had support for formats that were viewable on Windows, Apple and Android devices. Not sure if this is important to you. This was a few years ago and at the time Movie Maker did not have similar support.
 
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