Sharing Surgical Knowledge with Video and the Mac

Apple technology simplifies life for a New York neurosurgeon

On 250 mornings out of 365, Dr. David Langer scrubs up for a brain operation that will take most of the day. To a layman, Langer’s surgery is grueling stand-up work, even allowing for breaks: six to eight hours in the operating room, working with tiny blood vessels or nerve tissue magnified up to 11x and forceps with 0.5mm tips. His operations can be life-changing and often life-saving.

Langer has a passion for sharing these experiences. As an Assistant Professor of Neurosurgery at Albert Einstein College of Medicine, he makes them part of the curriculum. As Director of Cerebrovascular Surgery at St. Luke’s Roosevelt Hospital Center, he shares them with his colleagues at conferences. Finding the time to create brief, instructive movies from video recordings of surgical procedures was a major challenge. But Langer, a certified Mac fanatic, found a simple way.

“Using iMovie, I can literally put the whole case together with pre- and post-operative images and video clips of the surgery to make a nice little QuickTime movie of any patient, which I think is sort of a neat way of sharing information,” says Langer.

Pinpointing the Critical Minutes

The first movie-making problem Langer faced was a massive overabundance of raw material. Video of Langer’s long surgical procedures is captured by a Leica M525 OH4 overhead microscope and networked to his Mac Pro workstation for editing in iMovie. The problem is that an eight-hour operation, captured end-to-end, generates a mountain of video. Langer needs only three to five minutes of video to capture the important parts of the surgery. He became very selective about what he recorded.

“The kinds of cases I wind up recording are usually the most interesting ones, the more esoteric ones, that you want to be able to show to your colleagues,” says Langer. “In other words, the most difficult ones, the higher-stress cases. The last thing I want to be thinking about during those procedures is recording and pausing. If you wear too many hats in the operating room you lose your focus. But you do want to limit the file size so you don’t have so much editing to do.”

Langer copes by using a foot switch or a finger switch, or the help of a nurse, to capture only the most meaningful sequences of his operations. The video clips are sitting on his Mac Pro when he returns to his office. iMovie helps save his limited time by streamlining the editing process.

“For busy surgeons with a limited amount of computer savvy – and that means most of us – the Mac makes things simpler,” says Langer. “It doesn’t take long to get proficient. I took an iMovie course at the Apple Store, then used iMovie to make video montages with my kids and set them to music. After I learned that, the OR stuff was simple. The videos on my website were all made in iMovie.”

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