Surgical illustration: the role, the reason, and the route.

Surgical illustration plays a fundamental role in the surgical field, being able to convey imagery in a more comprehensive way. However, its utility has seen a decline and being slowly replaced by photographs and 3D models. Surgeons are in a unique position that is optimum for producing surgical illustrations due to having direct contact and possesses a deep knowledge of the subject being drawn. The process of producing an illustration may also be valuable to the long-term conceptual understanding of that surgeon. This article aims to highlight the field of surgical illustration, its future potential, and act as a guide for surgeons to start illustrating.

Digital art - a useful tool for medical professionals to create medical illustrations.

Illustrations are routinely used in medicine for teaching, communication, record keeping, research and publication purposes. Many medical professionals including the author prefer to create their own medical illustrations for use in presentations and publications. With the advent of digital media, it has become easier to create good quality illustrations even for those with limited artistic skills including the author. This article describes the author's experience with creating medical illustrations using digital media and discusses the benefits of the new technology. A few useful tips are also provided for medical professionals who would be interested in exploring the option of creating their own illustrations using digital tools.

Depicting surgical anatomy of the porta hepatis in living donor liver transplantation.

Visualizing the complex anatomy of vascular and biliary structures of the liver on a case-by-case basis has been challenging. A living donor liver transplant (LDLT) right hepatectomy case, with focus on the porta hepatis, was used to demonstrate an innovative method to visualize anatomy with the purpose of refining preoperative planning and teaching of complex surgical procedures. The production of an animation-enhanced video consisted of many stages including the integration of pre-surgical planning; case-specific footage and 3D models of the liver and associated vasculature, reconstructed from contrast-enhanced CTs. Reconstructions of the biliary system were modeled from intraoperative cholangiograms. The distribution of the donor portal veins, hepatic arteries and bile ducts was defined from the porta hepatis intrahepatically to the point of surgical division. Each step of the surgery was enhanced with 3D animation to provide sequential and seamless visualization from pre-surgical planning to outcome. Use of visualization techniques such as transparency and overlays allows viewers not only to see the operative field, but also the origin and course of segmental branches and their spatial relationships. This novel educational approach enables integrating case-based operative footage with advanced editing techniques for visualizing not only the surgical procedure, but also complex anatomy such as vascular and biliary structures. The surgical team has found this approach to be beneficial for preoperative planning and clinical teaching, especially for complex cases. Each animation-enhanced video case is posted to the open-access Toronto Video Atlas of Surgery (TVASurg), an education resource with a global clinical and patient user base. The novel educational system described in this paper enables integrating operative footage with 3D animation and cinematic editing techniques for seamless sequential organization from pre-surgical planning to outcome.