The iPhone, the reflex, and the vinyl record: is the smartphone taking the best intraoperative photographs?

Surgical field photography is a tough exercise: surgeons dedicate the required time for photography even during complex surgeries; the intense lighting of the operating field works against photography, and the surgeon has to utilise whatever equipment is available. We selected five complex interventions and two surgeons (one with an iPhone® and one with a Digital Single Lens Reflex [DSLR] camera) who each took a photograph of the operating field. The source of photographs was blinded, and the image quality was scored using a 5-point Likert scale by three groups of team members with differing experiences: six senior surgeons, two junior surgeons, and four surgical residents. We evaluated the resolution (adequate for clinical interpretation), colour (appear true and natural), contrast (adequate to distinguish different structures), and overall quality. The mean ± SEM overall image quality was similar for both the smartphone and DSLR (3.7 ± 0.1 vs. 3.8 ± 0.11; p = 0.87), as were most of the scores for each image characteristic. Surgeons seek objectivity and efficiency. The smartphone is a more convenient photographic equipment and produces identical results than the DSLR. Human beings can be sensitive to image quality. The DSLR image was found to be sharper, however, this was found to be imperceptible.