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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_6023_Библиотеки_им_академика_М_И_Перельмана.pdf
Editing andPresentation ofSurgical
Videos
‘‘Seeing is believing.’’ With the growing vitality of international ophthalmological
academic exchange and the rapid expansion of digital platforms, surgical videos
have become increasingly indispensable for academic dissemination. Along with
traditional printed materials, these videos now constitute a core component of
scholarly literature, offering a depth of information—particularly in the visualization of intricate operative details—that remains unparalleled by traditional print
media. (1) Enhanced visualization of micro-surgical maneuvers; (2) Rapid dissemination across global academic networks; and (3) Intuitive learning experiences that
bridge the gap between theory and practice.
A vast array of desktop and mobile software is now available for video production, most of which are highly accessible and capable of meeting basic surgical
documentation needs. However, many practitioners still lack a comprehensive grasp
of the essential concepts and technical nuances required to create professional surgical media. (1) Selection of appropriate hardware and recording systems to ensure
high-denition clarity; (2) Implementation of standardized editing workows to
optimize operative time and educational value; and (3) Adherence to ethical guidelines, particularly regarding patient anonymity and data security. By starting with
the fundamental elements of high-quality media, this chapter utilizes practical
examples to guide the reader through the entire process of editing and presenting
vitreoretinal surgical videos.
13
13.1 Unique Characteristics ofVitreoretinal Surgical Videos
Unlike other ophthalmological subspecialties, vitreoretinal surgery possesses distinct advantages for video production, characterized by the following
features:ophthalmological subspecialties, vitreoretinal surgery has distinct advantages for video production, including the following:
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2026
Z. Zhang, U. Spandau, Vitreoretinal Surgery,
https://doi.org/10.1007/978-3-032-25271-5_13
265
266
13 Editing andPresentation ofSurgical Videos
1. Complex and diverse surgical maneuvers that provide a wealth of material for
clinical demonstration
2. A wide spectrum of surgical difculty, making these videos suitable for diverse
audiences and academic events at all levels
3. A vast variety of pathologies with well-dened themes, allowing for diverse pre-
sentation styles and a high degree of novelty
4. A clear and continuous narrative structure that guides the viewer through the
procedure, providing inherent educational value
5. An extensive operational scope with distinct anatomical layering, where the pro-
gression and switching of intraoperative views signicantly enhance the video’s
engagement and visual appeal
13.2 Core Elements ofSurgical Videos
A standard surgical video must include the following four core elements:
(1) Clarity
As the most fundamental element of a surgical video, clarity is the prerequisite for
showcasing all other features. It mainly depends on three factors:
1. Hardware support (e.g., microscope resolution and camera pixel count)
2. Parameter settings (e.g., microscope magnication and focus adjustment)
3. Refractive media (e.g., opacication of the cornea or lens signicantly reduces
video clarity)
(2) Educational Value
As the core and soul of any surgical video, educational value dictates that the images
are not merely simple recordings but essential carriers of surgical theories and techniques. To maximize this value, editors should focus on the following: (1) Identifying
and extracting specic clinical problems encountered during the procedure; (2)
Proposing clear, evidence-based solutions to these challenges; and (3) Utilizing
concise video segments to help viewers intuitively understand and master complex
surgical knowledge.
(3) Coherence
Surgical videos follow a linear timeline, sequentially presenting clinical challenges
and highlighting critical intraoperative details. To effectively convey embedded
knowledge within a limited timeframe, the production should adhere to the following principles: (1) Ensuring all surgical segments are highly relevant to the primary
theme; (2) Maintaining a continuous and logical narrative ow to guide the viewer’s
cognitive process; and (3) Focusing on the seamless integration of visual evidence
and theoretical explanations to enhance educational impact.
13.3 Basic Parameters ofSurgical Videos
267
(4) Storytelling
A surgical video without a clear narrative structure risks presenting disjointed content, thereby failing to convey a compelling message. Each surgical case represents
a unique clinical narrative, and many exceptional cases are overlooked due to a lack
of effective presentation. Video editing provides the opportunity to transform these
outstanding cases into compelling stories, thereby amplifying their educational
impact. Consequently, before commencing the editing process, editors should
undertake the following steps: (1) Conduct a thorough analysis of the case’s key
characteristics and clinical signicance; (2) Strategically consider the intended display scenario and target audience; and (3) Ultimately, present a cohesive and
impactful nal product that seamlessly integrates medical expertise with artistic
presentation techniques.
13.3 Basic Parameters ofSurgical Videos
(1) Frame
The basic unit of a video. Continuous playback of static images creates the illusion
of motion in the human eye (due to visual persistence); each static image is
one frame.
(2) Frame Rate
A key parameter for video submissions, as different platforms may have varying
frame rate requirements. It refers to the number of frames played per second, measured in frames per second (fps). A higher frame rate makes the video smoother, but
it is not always better—24fps is generally sufcient for good smoothness.
(3) Aspect Ratio
The ratio of a video’s horizontal length to its vertical length, which determines the
video’s shape. The 4:3 aspect ratio is rarely used for surgical videos today; the most
common is 16:9. This ratio feels natural for daily viewing, fully displays image
information, and matches the aspect ratio of most modern electronic displays, making it widely accepted. However, for ophthalmic surgeries, the 16:9 ratio leaves
large black areas on both sides of the video—these areas can be used to add video
details and increase information content.
(4) Resolution
Refers to the pixel dimensions of a video image, usually expressed as width ×
height, such as 1920 × 1080 pixels. When a video is enlarged several times, small
squares (pixels, the basic units of the image) become visible. In video terminology,
“4K” generally refers to a horizontal resolution of approximately 4,000 pixels,
although consumer 4K/UHD commonly uses 3840 × 2160 pixels. Higher resolution
improves clarity but requires better device performance and longer time for transmission and downloading. Thus, excessive pursuit of high-resolution during video
storage may cause device lag.
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13 Editing andPresentation ofSurgical Videos
Unless specied otherwise, the common resolution for vitreoretinal surgery videos is 1920×1080 (1920 pixels horizontally and 1080 pixels vertically). This resolution fully displays surgical details and is well-supported by most electronic
devices, ensuring smooth playback.
(5) Bitrate
The amount of data transmitted per unit time, usually measured in kilobits per second (kbps). A higher bitrate generally preserves more image information and produces a le closer to the original recording. Bitrate is proportional to video quality
and le size; exceeding a certain bitrate has little effect on improving image quality.
For 1080P videos, the recommended bitrate is 5000–8000kbps. To ensure optimal quality, the selected bitrate should match the camera’s recording bitrate as
closely as possible.
(6) Codec
A codec is a method or standard used to encode and decode video data, primarily to
compress le size for easier storage and transmission.
The most common codec for surgical videos is H.264/AVC, a video compression
standard established in 2003 with high compression efciency, strong error resilience, good network adaptability, and high video quality. The newer H.265/HEVC
standard (ofcially adopted in 2013 to expand H.264/AVC) offers even higher compression efciency, reducing storage space for high-resolution videos and improving playback speed. It is expected to become mainstream as device performance
improves.
(7) Format
Format selection is a common yet easily solvable issue in surgical video editing.
The current general requirements are MP4 or MOV formats:
• MP4: A widely used multimedia container format that can store video, audio, subtitles, and other data. It is commonly encoded with codecs such as H.264 or H.265.
Note that MP4 is not equivalent to MPEG-4—MPEG-4 can be used in formats like
MP4, MOV, and AVI.MP4 is supported by most electronic devices and takes up less
storage space; it is the default choice unless specied otherwise.
• MOV: Developed by Apple Inc., it has a slightly lower compression ratio than
MP4 and higher video clarity. Like MP4, it has good cross-platform compatibility but is less widely supported. It works well for playback and editing on Apple
devices.
A common problem for beginners is that the editing software does not support
original video formats (e.g., AVI and MPG). Format conversion software is required,
but this often reduces clarity or causes segment loss. The best solution is to set the
original video format to the universal MP4 or MOV from the start to maximize editing efciency and video clarity.
ab
13.4 How toAdjust Your Camera andMicroscope
269
(8) Depth of Field (DOF) of the Microscope
Also called focal depth, it refers to the range within which the image remains clear
when adjusting the distance between the objective lens and the sample surface (during microscopic observation or recording). Since the human eye’s adjustment ability varies, DOF can differ between individuals.
13.4 How toAdjust Your Camera andMicroscope
(1) Adjustment of Focus and Refraction
Microscopes are designed with a DOF; in vitreoretinal surgery, a larger DOF is
highly advantageous as it minimizes the need for frequent manual focus adjustments. Ideally, the microscope’s built-in camera has a xed focus that is parfocal
with the eyepieces. If the surgeon maintains an emmetropic state throughout the
procedure, the images seen through the oculars and captured by the camera will
share the same clarity, requiring only standard adjustments via the foot pedal.
However, many surgeons—particularly younger ones during delicate macular or
anterior segment maneuvers—frequently experience instrument-induced myopia
(or instrument accommodation). In this state, emmetropic individuals develop temporary myopia, while myopic individuals experience a transient increase in their
refractive error. To compensate for this subjective blur, the surgeon often inadvertently adjusts the microscope’s focus via the foot pedal to offset the refractive deviation. This action shifts the focal plane relative to the xed-focus camera, resulting in
a recorded image that is signicantly blurred despite the surgeon seeing a sharp eld
(Fig.13.1). Although this phenomenon does not hinder the surgical execution itself,
Fig. 13.1 Blurred display image due to microscope focus adjustment after the surgeon develops
instrument-induced myopia. (a) Before instrument-induced myopia: The display image and the
image seen by the surgeon through the microscope eyepiece have nearly the same clarity; (b) After
instrument-induced myopia: Adjusting the microscope focus causes mild defocusing of the display
image, but the image seen by the surgeon through the eyepiece remains clear—the surgeon is
unaware of the blurred camera image
270
it severely compromises video quality, a technical aw that is often only discovered—much to the surgeon’s regret—during post-editing.
To solve this problem: First, adjust the display image to maximum clarity. Then,
adjust the diopter on the microscope eyepiece to offset instrument-induced myopia
(usually −1.00 to −3.00diopters).
If the microscope is equipped with an external camera, simply adjust the cam-
era’s focus manually (no need to adjust the eyepiece diopter) to obtain a clear image.
To record a clear surgical video throughout the process, the surgeon and assistant
should dynamically adjust the setup based on the display image at all times to avoid
missing important operational details.
(2) Brightness Adjustment
Brightness is critical to video clarity: insufcient brightness causes excessive noise,
while excessive brightness leads to overexposure and loss of details. Brightness
adjustment mainly involves two scenarios:
1. For anterior segment surgery: Adjust the microscope brightness to clearly visualize iris texture.
2. For posterior segment surgery: Adjust the brightness of the light guide ber. The
ber’s end should not be too close to the retina. With a non-aging bulb, the
brightness is generally set to 35%–40% of the maximum.
13 Editing andPresentation ofSurgical Videos
(3) Magnification Adjustment
Too low magnication limits the surgical eld to a small area of the video. Cropping
during postediting will enlarge the image, reduce overall resolution, and cause
noise. Too high magnication may make the surgical eld exceed the video frame,
resulting in lost details. For posterior segment surgery, adjust the microscope magnication so that the upper and lower edges of the surgical eld are slightly close to
the upper and lower edges of the video frame
13.5 Choosing theRight Editing Software forEfficiency
andQuality
For surgical video editing, regardless of the software type (Table13.1), the following points should be noted:
1. Do not reduce video quality.
2. Allow cropping to center the surgical eld.
3. Have moderate hardware requirements.
4. Use appropriate artistic elements (e.g., transitions and titles)—avoid being too
dull or overly fancy to maintain academic rigor.
13.5 Choosing theRight Editing Software forEciency andQuality
271
Table 13.1
Software
type
Adobe
Premiere Pro
CapCut Easy to use, free, fully
Final Cut
Pro
iMovie Easy to use, stable
MOV AVI Clean and user-friendly
Corel
VideoStudio
Windows
Movie
Maker
Advantages and disadvantages of common video editing software
Advantages Disadvantages
Versatile, wide
application range, strong
image editing functions,
meets almost all surgical
video editing needs
functional, meets almost
all surgical video editing
needs
Professional-level
editing, simple operation,
stable performance,
smooth running;
auto-saves edited les;
supports multiple effects
via plugins
performance, autosaves
edited les; meets basic
surgical video editing
needs (suitable for
general editing or rough
cutting, with further
processing via other
software)
interface; built-in
multiple video
processing effects;
supports multiple formats
Simple operation,
streamlined editing
process, user-friendly
interface, high system
stability
Preinstalled on Windows;
very easy to use; smooth
performance; supports
multiple formats
High system
requirements, prone
to computer lag;
requires frequent
saving; relatively
high operation
difculty; paid
Artistic effects tend
to be
-entertainmentoriented
Paid; only supports a
few formats (e.g.,
MP4 and MOV);
other formats require
conversion rst
Monotonous artistic
effects; only supports
a few formats (e.g.,
MP4 and MOV);
other formats require
conversion rst
Paid; high system
requirements; prone
oriented artistic
effects
Paid; monotonous
effects;
-entertainmentoriented
No longer updated;
limited functions;
difcult to download
Operating
system
Windows,
MacOS
Windows,
MacOS
MacOS High
MacOS Medium
Windows,
MacOS
-to lag; entertainment-
Windows,
MacOS
Windows Low
Recommendation
Medium
High
High
Medium
Various software options are available (briey introduced below). For beginners,
it is often difcult to create high-quality surgical videos with a single software in a
short time. Combining multiple software (leveraging each strengths) can achieve
twice the result with half the effort.
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13 Editing andPresentation ofSurgical Videos
13.6 Fundamental Steps andMatters Needing Attention
Taking CapCut Desktop Version as an example, this section explains the basic process and precautions for surgical video editing. Beginners can choose multiple editing software based on their habits to meet different needs and scenarios.
(1) Video Shooting and Storage
Surgical videos are usually recorded by the microscope’s built-in camera and stored
in real time on a computer hard drive or cloud system. To ensure compatibility with
playback and editing software, it is recommended to set the original video format to
the mainstream MP4 or MOV to avoid clarity loss or segment loss during
post-conversion.
For videos to be edited, use a large-capacity hard drive (usually ≥1 TB) for
timely storage and backup. Rename and archive the les promptly for easy retrieval.
(2) Starting Editing
After preparing the videos, open the software and click “Start Creating” (Fig.13.2)
to enter the workspace (Fig.13.3).
(3) Importing Materials
Click “Import” in Area A, select the original video and other media to be integrated
into the video from the hard drive, and drag the video from Area A to Area D
(Fig.13.4).
Fig. 13.2 Opening interface of CapCut Pro: Click “Start Creating” to enter the workspace
13.6 Fundamental Steps andMatters Needing Attention
Fig. 13.3 Four workspaces of the software. Area A (“Browser” panel): Manages materials,
imports videos, audio, images, etc. Area B (“Player” panel): Views video editing details in real
time. Area C (“Inspector” panel): Views metadata, adjusts parameters, edits subtitles, etc. Area D
(“Timeline” panel): Edits and processes all media
273
Fig. 13.4 Drag media les from Area A to Area D to start editing
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13 Editing andPresentation ofSurgical Videos
(4) Rough Video Editing
In Area D, use the video split tool to divide the original video into segments, and
requiring step in surgical video editing (Fig.13.5).
(5) Image Adjustment
1. Image cropping: Due to magnication adjustments and surgical eld shifts, con-
tinuous cropping is often needed to keep the surgical eld centered (Fig.13.6),
then delete unnecessary parts. This is the most time-consuming and patience-
Fig. 13.5 Area D has multiple function buttons for splitting, cutting, and deleting video segments
Fig. 13.6 Click the “Crop” button in Area D to crop the video segment; keep the surgical eld
centered and maintain a constant aspect ratio