An Easy, Efficient, and Safe Method for Intraoperative Digital Photography by Smartphone

Accurate intraoperative photographic documentation in reconstructive and aesthetic surgery is essential for clinical, scientific, and medicolegal purposes.1,2 Thanks to their high-quality sensors and portability, smartphone cameras are presently recognized as optimal performance devices in the field of medical photography. Generally, taking photographs in the operating room requires the surgeon or assistant, using double gloves, to take the picture; then he removes the outer gloves to continue the procedure. This action is repeated several times during the operation, and it is time and money consuming. It also represents a risk for potential contamination of the operative field. Often extra staff members help surgeons in taking photographs: it may be faster and safer in terms of contamination, but it may be difficult to have the knowledge of the detail that the surgeon wants to be photographed. Furthermore, the quality of pictures is operator dependent and may not respect the criteria of ideal images. In order to avoid these disadvantages, we adopted a personal technique, allowing the surgeon to take pictures by himself (Supplementary Data, available as Supplementary Data at www.aestheticsurgeryjournal.com). The setup is described below. The sterile polyethylene disposable camera cover. The draping process. Smartphone ready to take intraoperative photographs. The smartphone in a sterile camera cover can safely be brought extremely close to the surgical field to take accurate pictures. An intraoperative photograph taken with a phone through the cover. This technique is applicable to any smartphone and the materials used for the “homemade” cover are easily available in any operating theater. The sterile polyethylene disposable camera cover used in our clinic has a cost of €2.05 per unit. There are not additional costs for operating room time spent only for photography preparation: to save time, the draping process is done while the instrument nurse prepares the instruments table. The quality of the picture is very good, with the photographic angle matching the surgeon's viewpoint. Interruption of the operative procedure and risk of contaminating the operative field are minimal. La Scala and Fisher3 in 2001 described a simple, cost-effective technique that allows the surgeon to take good-quality images without significant interruptions of the procedure, using a video camera drape sleeve to cover the digital camera. Others authors described the use of a pre-sterilized waterproof camera case for taking intraoperative photographs, without significant risk of contamination.4,5 There are notable price differences between our own and other systems: the video camera drape sleeve used by La Scala and Fisher3 (EZSERT Video Camera Laser Drape, Ref. 9604, Microtek Medical Inc., Columbus, MS,) costs $25.53 per unit ($638.47 for a box of 25 pieces);6 the waterproof camera case used by Raigosa et al4 (Sony MPKTHA Marine Pack for the DSCT1 Digital Camera) is available for $44.957 or $100.008; and the waterproof camera case used by Tsai et al5 (WP-FXF30, Fujifilm Inc., Japan) costs $108.009 or $184.95.10 Our experience confirmed that it is possible to realize a safe, efficient, easy to perform, and low-cost method for intraoperative photographs acquisition. The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article. The authors received no financial support for the research, authorship, and publication of this article.