Response to Video Capture of Plastic Surgery Procedures Using the GoPro HERO 3+: Patient Privacy and Compliance.

Supplemental Digital Content is available in the text.

Sir:

We were encouraged by Dr. Song’s use of a head-mounted GoPro camera for recording plastic surgical procedures.[1] After consulting with the legal and compliance offices of our institution, we developed a protocol for using a head-mounted GoPro camera that respects patient privacy laws and policies.

At our institution, consent to recordings is included in the “General Consent for Treatment.” Nonetheless, we explicitly ask every patient for permission. So far no one has objected. One patient actually requested that we record his procedure to show his daughter to fuel her interest in surgery.

The hospital policy on “Recordings of Patients, Staff and Visitors” affirms the right of staff members to refuse to be recorded. We announce at the beginning of each surgery that both video and audio will be recorded. We obtain verbal consent from each member of the operating room. Those who do not consent are relieved by other staff members. A sign is placed outside the door to indicate that video and audio recording is in progress.

The GoPro is not considered a personal communication device as it has no connectivity to mobile telephony or the internet. Its password-protected wireless connection is limited to one other device such as a GoPro Remote or an iPhone running the GoPro app. As with any digital camera, our hospital policy on “Information Security” requires encryption for protected health information and confidential information stored on removable media, such as the GoPro’s microSD card. Therefore, we do not begin recording until after the preincision time-out, and the camera operator keeps the GoPro aimed at operating level or below to avoid capturing the patient’s identifying information on the procedure whiteboard.

We used the GoPro Hero3+ Silver at 1080p, 29.97 frames per second, and narrow field (90° field of view). The camera was able to spot meter on the operator’s center of vision. Using loupes provided more consistent white balance and focus, and the operator’s limited field of vision was better aligned with the camera’s center of frame. Images had sufficient resolution to visualize FDP tendon fibers (Fig. 1) and to discern the subcompartmentalization of APL tendons (Fig. 2). The GoPro setup made it natural for the attending surgeon to teach to the camera and to the resident at the same time (See Video 1, Supplemental Digital Content 1, which displays the ulnar nerve being transposed under the common flexor tendon. This video is available in the “Related Videos” section of the full-text article on http://www.PRSGlobalOpen.com or available at http://links.lww.com/PRSGO/A151). Using Final Cut Pro, the fish-eye distortion was corrected, and the recordings were cropped and condensed to include only the key parts of the procedure, for use in case presentations.

Fig. 1.

During repair of the FDP tendon, a 4-0 supramid suture was placed on the proximal cut end in a locking looped fashion.

Fig. 2.

The first extensor compartment of the wrist has been released, and the subcompartment of the APL tendons was about to be released.

Video 1.

See video, Supplemental Digital Content 1, which displays the ulnar nerve being transposed under the common flexor tendon. This video is available in the “Related Videos” section of the full-text article on http://www.PRSGlobalOpen.com or available at http://links.lww.com/PRSGO/A151.

Head-mounted video cameras have great potential in surgical education, especially in rare procedures at academic hospitals. The visual detail and audio narration convey vastly more information than textbook description or operative notes. It is important to review institution-specific policies on video recording.

DISCLOSURE

The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.