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1. Declaration Mr David Haider has no financial interests related to this subject Mr David Haider Specialty Registrar in Ophthalmology Manchester Royal Eye Hospital Correspondence Email dhaider nhs net Recording Microsurgery another way Te ability to record and review surgical procedures is an important aid to self evaluation of surgical progress It serves as an aid in the training of cataract surgery and often helps to convey important surgical con cepts during presentations The ideal system should allow easy playback of the video as well as straightforward editing and transfer to a home computer At present there are numerous ways to record microsurgery or non micro surgery if you have external cameras Below list the most common methods used and their relative merits and shortcomings also present a system which although requiring an initial financial outlay functions very well and addresses the weaknesses of other methods Existing methods VHS recorder VHS recorders are still commonplace in operating theatres though rarely used Although easy to use editing is difficult and conversion to digital for mats for use in computer presentations is also complex and this greatly lim its their utility DVD recorder This increasingly common type of recorder has a few important shortcom ings The first problem many face is incompatible discs Many DVD recorders only work with a particular DVD type DVD2. Once you ve found the connector you need to look at what shape it is If it is a smooth round socket known as a phono or RCA socket see photo 1A you need nothing else and the yellow plug on the cable that came with the DVR Travel Adaptor will plug straight in see photo A Cable from microscope to recorder Video In Microscope Camera 1B If the video out connector is round with two small metal pins sticking out see photo 1C you ll need a 3 converter from Maplin electronics Maplin product code FAM or elsewhere see photo 1D inset This will turn the yellow plug on the end of your Archos cable into one that will fit the video out socket see photo 1D Now you ve found out where you will get video from all that remains is to buy the equipment Even if you don t think you need the Maplin adaptor would advise buying it It may come in handy when you are next in a different theatre Recording your first video e Read the Archos manual e Ensure the Archos has been fully charged If you havent got the mains adaptor this could take up to 12hrs via the USB cable provided e Turn the microscope etc on e Connect to yellow plug on the end of the cable to the video out you have chosen see set up guide Note the red and white plugs are for sound and you won t be recording that so leave them alone e Attach the DVR Travel Adaptor to the Archos and the cable to the adaptor see photos 2A to 2B Your Archo
3. article e Check it works by opening the video file The files should play fine in win dows media player but recommend downloading a program called VLC It s a small program and it plays most videos without any fuss Just Google VLC e Within PowerPoint or Keynote simply choose to add a video and navigate to the file concerned If you just want a small snippet of the video suggest editing the file on the Archos and sav ing the clip as a new file Recording non microsurgery The DVR Travel Adaptor can also be bought with a small camera a little big ger than a roll of pound coins One of its aimed uses is to attach on to a helmet to record mountain biking or snowboarding etc There is nothing to stop an oculoplas tic surgeon securing the camera to his loupes and recording surgery that way The accessory is called the Archos Helmet Camera If you buy it you dont need the DVR travel adapter as that is included Future versions of the Archos Every year or so the Archos company release a new generation of devices In fact a new generation has recently been released September 2008 The Archos 5 as it is called is in some ways a new ver sion of the Archos 605 It is currently about 100 more expensive than the 605 For the extra 100 you get a larger hard drive and support for HD high definition video The addition of HD is not a real ben efit as microscope cameras are not high definition The Archos 5 doe
4. selected on the Archos and it begins to record After recording is stopped the user can use the touch screen to replay the video or a certain part of it very easily The screen on the Archos is large enough to replay the video and see details necessary for teach ing The touch screen can also be used to perform basic trimming and editing of the video Editing now done the Archos can be plugged into a computer with the provided cable The Archos will appear much like a USB memory stick The recorded videos appear as files and can be copied directly to the hard drive From there they can be imported directly in to PowerPoint or Keynote as it s also Mac compatible article OUT PUT gt VIDEO Picture 1 Connecting to the video output signal Advantages over other methods e Adaptable to different theatre environments Relatively low cost minimum require ments 200 e Easy to edit on device e Easy to watch videos back on screen or can be connected to a TV Easy to copy videos to PC MAC e Large capacity hard drive can store hours of video Very portable No tapes or discs e Also functions as a very good way to watch a film when travelling Requirements Below are requirements listed the minimum Archos 605 The 605 is available in various capacities AGB is the minimum and 30GB is the next one up I have the 30GB model It is more than big enough would avoid the 4GB model and only get larger
5. R for example Although DVD R discs look the same they will not work in such recorders The process of clos ing or finalising a DVD needs to be performed once recording is completed Omitting this step will prevent you extracting video from the disc via your home computer Transferring video to a computer and editing clips is not straightforward on a PC DVDs were not designed for this If you put one ina computer you will not find nice files that you can load into PowerPoint To successfully get some of your surgery into PowerPoint you first need to rip some or all of the video from the disc This requires special software that generally doesn t come with your computer There are an overwhelming number of products to choose from and often involve expense Even with software installed the process can be time consuming and confusing In summary DVDs often turn out to be a headache consuming most of a weekend Mini DV Digital Video This method uses Mini DV tapes the small digital tapes used in many cam corders If your theatre has such a recorder recording is very easy Playback for teaching in theatre is also not too painful The problem again comes with transferring video to a computer and editing Few people have facilities at home to accomplish this A compatible camcorder could be used and often comes with suitable software to load on your computer With the right equipment Mini DV is a great option but getting the right equipm
6. than 30GB unless you have a good reason not to Remember you can store any videos on your home computer They don t need to stay on the Archos DVR Travel Adaptor This is necessary to connect the micro scope camera to the Archos It is small and hence portable The DVR Station below has more features but adds bulk and isn t necessary Optional extras Mains charger The Archos does not come with a mains charger and must be charged from a com puter A mains charger is almost essential recommend the model called the Archos Mains Adapter 500677 To use this charger the DVR Travel Adapter must be connected This charger also allows the recorder to be charging when recording surgery which is essential if your battery is low Archos DVR Station Gen 5 Dock This is a recording cradle for the Archos that also functions as a charger It could be kept connected at work if desired Buying this removes the need to by the Archos DVR Travel Adaptor and mains charger It also lets you connect the Archos to a TV to watch the videos back It is much larger than the DVR Travel Adaptor so if you don t want to leave it set up at work get the DVR Travel Adaptor For home use the DVR Station will allow you to schedule TV to be recorded on the Archos It also comes with a remote control Mini Dock In the same way that the DVR Travel Adaptor allows you to record the Mini Dock allows you to hook the Archos to a TV and watch films or
7. ent is costly Personal camcorder Taking your home video camera to work with you and hooking it up to your theatre camera is actually a surprisingly good option Assuming your cam corder has a video input facility it will record high quality video on to tape CD DVD or a built in hard drive The software that came with the camera can then be utilised in order for you to copy the video to a home computer and complete any required editing The camera can also be used to play the video back while in theatre The main problem with a camcorder is transporting it to work If you are trying to get into the habit of recording all your microsurgery in order to critique your technique this could be inconvenient An ideal solution The method use for recording microsurgery is to use a portable media player an Archos 605 If you are unfamiliar with the terminology think of it as an iPod for video that can record It s a small box a bit smaller that a CD case but slightly thicker The front surface is for the most part dedicated to a high quali ty touch screen Inside is a hard drive like in a computer that can be used to record video Overview Below briefly describe how the Archos is used The output of the microscope camera is connected to the Archos via a cable and adaptor This usually means plugging a wire in to the back of an existing DVD or VHS recorder already present in the theatre Next the recording mode is
8. ide For this will assume you will be using an Archos 605 DVR Travel Adaptor The first thing to do is find a good place to get the video signal from I would explore this before buying the Archos You are looking for a connector in your theatre labelled video out The best place to get this will vary depending on equip ment already installed In general look at the camera on the microscope and try to work out the first box on the side of the room that it goes to If there is a free con nector on the back of that box labelled video out that s what you want If there is no free video out connector look at the back of the next box that the wires go to Typically you ll find a video out connector on the back of a VHS recorder DVD recorder camera controller or screen There may be other video out sockets labelled S Video component or RGB These cannot be used without additional equipment For those with a little more technical understanding the DVR Travel Adaptor will only take composite video It will not take S Video or component If you buy the DVR Station however that does have the capability to accept those signal types Even though they are higher quality the video often leaves the camera as compos ite and therefore you wouldnt see any benefit I ve tried a direct comparison of the video produced with the DVR Travel Adaptor vs the DVR Station via S Video and component and can t appreciate any difference
9. s should now be wired up similar to the simplified diagram see diagram 3 Video Out S lt Archos 605 lt DVR Travel Adaptor Press to begin recording Existing VHS DVD recorder or camera controller _ Unused connectors lt lt to record sound Archos recording cable Picture 2 Atttaching DVR travel adaptor charging and recording Turn the Archos on and enter the record ing mode by pressing the appropriate button on the screen see photo 2C If you ve done everything right the screen should resemble photo 2D Test this by looking at the screen while wav ing under the microscope If you get no picture try another video out if possi ble If you still have problems very rare try resetting the Archos and trying again e To begin recording tap the REC symbol at the bottom left of the screen e Scrub and operate e Press stop Playback and editing are straightforward and are well covered by the user manual Copying files to a PC or Mac e Follow instructions in the manual to plug the Archos in via provided USB cable e Archos will appear much like a memory stick Open the Archos and you ll see the folders inside All the files you ve recorded are stored in the folder called Rec They are dated and timed If you ve done any editing you may have an orig inal file and an edited file e Copy appropriate file s from Archos like you would a file from a memory Stick
10. s not add any features that will aid recording of surgery although the Archos 5 does look nicer than the 605 Please note that the Archos 605 and the accessories referred to above are known as Gen 5 meaning fifth gener ation of the Archos line The new Archos 5 is one of the sixth generation Archos devices Accessories for the Archos 5 are Gen 6 and are NOT compatible with the Archos 605 The same type of accessories are required for the Archos 5 and they have similar names The exception is the DVR Travel Adapter which is called the Archos Gen 6 DVR Snap on when bought for an Archos 5 If readers wish they can email me specific questions If there is suf ficient interest will setup a discussion group so common questions can be answered feel it is also important to point out that have no financial interest in the products recommend From my experi ence they are the best tools currently available for the job To date know of five ophthalmologists who have bought an Archos 605 following my recommenda tion and know several others who are interested EN
11. videos on a TV This function can also be done by the larger DVR Station but at the cost of size The Mini Dock also comes in an alternate ver sion with an extended battery built in called the Battery Dock If you end up using your Archos to watch films while on a plane the extra power is useful It could also be used to connect your Archos to your hotel TV in case you want to watch a film you may have stored on it beats foreign TV or Sky News Archos 605 GPS The 605 can also be bought with a chunky car window mount that adds satellite navigation functions to the Archos lve never used it so can t comment Plug ins You can buy extra software for the 605 from the Archos website It is important to realise that the 605 has Wi Fi wireless built in and many of the plug ins increase the usefulness of that feature One adds web browsing software and others allow the Archos to play a wider variety of video and sound types None of these are essential for recording playing and editing surgery The 605 will also function as a nice iPod style mp3 player It has a headphone socket and a small speaker and will play mp3s No plug in required My advice Get the 30GB Archos 605 the DVR Travel Adaptor and a mains charger 500677 Think about the rest if you end up wanti ng to use the Archos for more than just recording surgery The total cost of those three is approximately 210 from Amazon as of December 2008 Set up gu
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