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4K Surgical Video Smartphone Tips

With such impressive advances in technology, today’s smartphone cameras are viable filmmaking-quality tools. While you may not be shooting a feature film on your iPhone—although technically you could (see the success of films such as Tangerine)— smartphone video is a thing and it can be a very useful tool in the operating room. If you're looking for the best ways to start recording high-quality video on your smartphone, check out this list of simple yet effective ways to enhance your surgery video content.

1. Optimize Smartphone Settings

Hidden away in your iPhone’s (or similar smartphone) camera settings are various options for video, most importantly resolution and frame rate.  iPhone 6s and later can shoot videos in 4K. If your goal is capturing the highest quality surgical video images - choose to film in 4K. iPhone 14 are capable of recording 4K videos at 24 fps, 25 fps, 30 fps, or 60 fps. Frame rate choice can vary depending upon your own use case. For most operating room surgical videos, I recommend filming in 4K at 30fps. Higher frame rates (60fps) can produce smoother UltraHD images when filming very rapid movements and when converting to slow-motion during editing. 30fps is an excellent choice when capturing most surgeries is preferred when uploading your iPhone 4K UHD footage to many online platforms (Vimeo, YouTube, LinkedIn, Instagram, or any other social networking site). A few additional tips to optimize smartphone settings in the operating room:

  • Utilize auto-focus/auto-exposure: Previously light-emitting diode operative room lights often resulted in over-saturation or flickering phenomenon. The latest Smartphone models utilize improved auto-focus and exposure compensation controls capable of handling operating room lighting very well.
  • Disable HDR Video
  • Disable ProRes. Pro model iPhones starting with the 13 Pro and Pro Max can shoot in ProRes, a capability aimed squarely at professional users. Filming in ProRes presents some rather serious limitations (it only shoots in 1080p at 30fps and the footage takes-up a huge amount of storage space. 1 minute of ProRes footage will take up 1.7GB of storage)

Recommended iPhone settings for operating room: 4K at 30fps or 60fps

2. Avoid Zooming (when possible)

Digital zoom uses a magnification technology within the camera to enlarge an area of the image. However, this also enlarges the pixels, reducing the image’s resolution and overall quality. If a substantial amount of “zoom” is required, the image’s quality decreases when enlarged. Most smartphone cameras offer both optical and/or digital zoom. However, the greater the optical zoom, the narrower the focal window for a clear image. the more you zoom in, the more you compromise the quality of your video footage. Use your zoom feature sparingly and get up close and personal with your subject when it permits. The more you zoom, the more you can compromise the quality of your video footage. Use zoom features sparingly and preserve video quality by leveraging magnification during editing.

3. Stabilize

Depending on your phone model, you may or may not have life-saving optical image stabilization (latest iPhone models have improved image stabilization technology, using both Optical Image Stabilization (OIS) and Electronic Stabilization, to stabilize shaky video recordings). Point-of-View smartphone recording of surgical procedures can be accomplished using a head mount system or gimbal stabilization when the smartphone is attached to a tripod or handheld device. When considering positioning and stabilization options, keep in mind the weight of the head mount or handheld assembly, which could potentially increase strain during longer procedures. Below is a list of some stabilization and mounting options when using smartphone cameras in the operating room:

4. Consider External Mic

If choosing to capture audio DURING the surgical procedure, your smartphone mic may fall short in the operating room environment. Audio upgrading and scaling can be completed during the editing process but there is a limit to how much you can improve audio in post-production.

With this in mind, you may want to check out some of the mobile microphones for use with smartphone (listed below). There are several options available that have been specifically designed with mobile video in mind. They are small and compact enough to not significantly increase the size/weight of your setup while offering a much higher quality of audio and the ability to block-out background noise. Since voice-over can be easily dubbed-in during the editing process, I have rarely used an external microphone while capturing surgical procedures. Outside of the operating room, I often use an iPhone + External Microphone set-up to optimize video quality. Here are a few of smartphone external mic models you may want to consider:

Summary: Smartphones in the Operating Room

These are a few essential tips on how to improve smartphone video quality in the operating room. By optimizing setting, positioning/stabilization and a few accessories, it’s truly astonishing what can be achieved. For such a small piece of technology that fits in our pocket, the advancements over the past decade and the powerful opportunities it provides are phenomenal.



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Cory Calendine, MD is an Orthopaedic Surgeon and founding partner of the Bone and Joint Institute of Tennessee at Williamson County Hospital in Franklin, TN. Dr. Calendine is an expert in Joint Replacement, specializing in Hip and Knee Surgery. From diagnosis through treatment, the Orthopaedic Surgical experts at the Bone and Joint Institute use the latest techniques and technology to improve care for people with musculoskeletal problems. For more information, please contact our office or schedule your appointment today.  

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