Surgical headlamp - preview

The bigger of the 2 headlamps I bought on ebay has arrived, the 800+ peso one. around 5 weeks from order time. Arrived 2 days ago and I've been busy so I haven't had time to test it out fully. More or less it looks like this.

So far i've used it to dress one patient and excise a lipoma. It seems bright enough and the light collimation/concentration is OK enough for what I call (I'll mention this headlamp classification in my blog post and my paper if and when it comes out) "against the light" usage with or without loupes, although I havent tested it like that yet.

"Against the light" is one of the classifications of medical headlamp usage that I invented. Its the most demanding. It essentially means its bright enough that you can use it to see into a deep body cavity which is in dark shadow because of OR lights. This situation often comes up with a resident coz the surgeon is operating somewhere else nearby and he's hogging the OR lights.

Elastic straps are slightly too small for my head but I can fix that easily. Battery charger is not the best and can damage the 18650 lithium batts if left to overcharge the batt but it works. The major modification I need to do is to make a remote switch so i can turn it on and off without breaking sterility (thats one of the differences between civilian and medical headlamps in an older blog post.).

After full modification and testing, I plan to write a post here and maybe enter it into next year's PCS surgical innovations contest thingie. Maybe even write a paper. But for now, it looks promising.

Again, this is only a preview. Stay tuned for a future blog post with a more in depth review.

The end

cree headlamp vs led lenser h7 for surgery

The cree headlamp was discussed here.

The led lenser h7 is available in hahn for 2800 pesos versus 1500 pesos for the cree. It is rated at 160 lumens versus 300 for the cree. Maybe the 300 value is exaggerated. But the led lenser H7 is a little weaker than the cree. The focusing system of the H7 is inferior to the cree. Just look at the cree's lens assembly, its so long compared to the H7. Just like a DSLR telephoto lens, if you want zoom , you need a longer barrel.

My bro in law has a cree and I have used it in surgery so I can safely say that its focus system is excellent. The cree has little spill while the led lenser has a lot of spill. Its intensity is probably the minimum needed for surgery. Sorry led lenser, I have to turn you down this once.

Conclusion: the cree headlamp is definitely usable for surgery.

surgical grade headlamp versus ordinary headlamp

* Spill. A hiker, spelunker or whatever uses both his peripheral vision as well as being focused on what is ahead. This is why most flashlights and headlights, aside from the bright spot, also have a lot of light that spills over. A surgeon does not use his peripheral vision much. If he is using loupes, he cant use his peripheral vision becuase he is totally concentrated on what is within the field of view of the loupe. The ideal surgical headlamp must have a very concentrated cone of light focused a handlength away, with little or no spill. Spilled light just wastes energy.

* Comfort. A surgical headlight must be utterly comfortable. I've used headlights that cause headaches when used for a long time unless you move it around. Surgeons can be wearing the headlight for hours so it has to be utterly comfortable. A surgeon cannot adjust the headlight by himself because he is sterile so there better be no pressure points that can cause pain and skin ulcers.

* Tilt adjustment. The led lenser headlights are notorious for this. The hinge has ratchets so the tilt can only be adjusted to a certain number of angles. If you are not wearing loupes you can just tilt your eyeballs up or down so that your field of vision conicides with  the focus of the light. If you are wearing loupes you cant do that. A work around is to move the headlamp up or down on the forehead. And the light better stay pointed where it is set. A surgeon can't easily adjust a headlamp once he is sterile.

* Coaxiality. If you're a hiker it doesnt matter if your light is a meter away from your eyes. You can still see. If however you are looking down a small pipe, then you need the light to be near your eyes. Most surgical lights have the emitter in between or maybe slightly above the line of sight

* Intensity. For a hiker, most likely it would be night time so even a weak light will help. A surgeon using a headlamp already has the operating light shining on the patient so his pupils will be already contracted. So the intensity needs to be high. Photographers would be familiar with this. Try photographing the contents of a tin can in bright sunlight without a flash, with the interior of the can in shadow. Thats what surgeons deal with all the time. Plus loupes tend to decrease the aparrent light intensity. However there are times when a weak headlight will work. These include office or bedside procedures or surgeries where the surgical light is focused on some other part of the body, as long as the headlamp does not have to fight against an operating room light. Of course you could just turn down the operating room light. But then your assistan and the nurses cant see anything unless you get them their own lights.

* Switch. A surgical headlamp ideally would have a switch that the surgeon can turn on and off without breaking sterility. You can macgyver this by installing a switch at say belt level. Just press the switch through your sterile gown.

* Modes. Most often you only need 2 modes, OFF and MAXIMUM. A normal user would maybe need other modes like flashing or low modes.

cree headlamps in the philippines

If you remember an older post here, I talked about this headlamp. Well, I found one for sale in the philippines. Well, at least it looks similar.

cree headlamp

CREE Q4 High Power Headlamp LED 300 Lumens Flashlight

Seller was smartshop.123. Took 39 days for the package to arrive in the mail from hongkong. It cost me US $0.99  or approximately PHP 45.46 + Postage US $12.99 and php 35 pesos handling fee at the post office.

Ok this is a generic, as in no brand light. Wait, didnt I promise that I wont buy generic lights anymore? Yes. Well am I breaking my promise? NO. Why? Simple, this isnt mine. I bought it for my bro in law.

Packaging was austere but OK. No manual though.

Now for build quality. The body is the usual cheap plastic. The lens and lens cover are made of plastic. The threads on the lens cover are plastic.

As you can see, the entire front of the unit detaches to gain access to the 3x AAA battery compartment.




The hinge is stepped and constructed of plastic. There are many steps so you can adjust the angle well.





The button is a bit small but it works. There appear to be 3 modes. Press once for high mode, press again for low mode then again for flashing. The ebay description says 6 modes. The lens casing can be pulled forwards for zoom or back for wide angle.

Here are side views of the beam at wide and zoom settings. I think I would advise covering the red band with aluminum foil to avoid spillage of light to the side.




The wide mode has a clean and clear 71 cm diameter round beam at 1 meter. No artifacts. At zoom, its an 11 cm wide square at 1 meter with minimal spill. Its square because thats the shape of the LED emitter. Its supposed to be a cree.




Compared to my led mini maglite 2nd gen 2 AA on the Left, its actually a bit brighter specially on zoom.




I dont have any rechargeable AAA batteries so there will be no burn times. All pics with the light on were done using 3 unomat AA batteries in a battery holder and the battery holder was connected to the headlamp's contacts with alligator clips.


So to summarize

build quality - plastic, but everything fits and works, 3/5 stars
price - 4/5 stars
light quality - its strong and the zoom is good - 5/5 stars
speed of delivery - 2/5 stars

update: My bro in law is a doctor like me. He's a urologist. Now, as surgeons compared to say hunters or spelunkers,  the zoom is very important because, specially if we are using loupes, we need a very very concentrated beam of light of high intensity focused at around hand length. Too low of an intensity and you would not even notice that the beam is on because it is drowned out by the operating room light. A hunter of a spelunker would need a less focused beam with a little spill over to illuminate peripheral vision. In the operating room, the spilled light would be a waste and would interfere with your assistants.

Let me give an example to illustrate. Imagine A mound of dirt that is waist high. You have a tall tin can buried flush to the ground. Its night so you have 1 strong spotlight that illuminates the mound of dirt. You are standing right next to the mound so the tin can is at wasit level. You can see the ground well but the bottom of the tin can is in shadow. You cant position the spotlight to illuminate the bottom of the can because your head blocks the light. Now in situations like that you will need a headlight. Actually a weak one will do  but only if you turn off the spotlight or direct it somewhere else. If the ground around the tin can's mouth is illuminated by the spotlight, then your irises will contract so you can't see the inside of the tin can unless your headlight is also strong. Photographers should be familiar with this problem.

Update: You can buy a model very similar to this except for the color for 1,500 pesos in local malls. I forgot the name of the store but its a small kiosk decorated in camoflage colors. It sells camoflage clothes, airsoft accessories and some generic and class A china LED flashlights. There are branches in Robinsons malls like Robinsons San Fernando Pampanga and Robinsons Ermita.

This particular model once modded with an external AA battery pack (for longer lasting AA nimh batteries) and an external switch (So a surgeon can turn it on and off without breaking sterility) is personally recommended by me for use as a surgical headlight. See this other blog post for more about surgical eadlights.