On last month's editorial page, our Editor, Julie Freischlag, MD, introduced the Archives’ new feature: online videos and solicited submissions. This month we are proud to feature the first, a beautiful video from Ishizawa et al in which indocyanine green was used to give real-time fluorescent visualization of the biliary tract during routine laparoscopic cholecystectomy. It is pretty remarkable. In the video one can easily differentiate the cystic duct from the cystic artery and visualize the common duct. It looks eerily like the image on the November 2008 cover of the Archives of Surgery of a hepatobiliary scan. About 50 seconds into the video, what I thought was a retained stone clearly turns out to be fat; the grasper moves the tissue away, revealing the pristine duct behind it. The video file is only 8.94 MB and lasts for about 1 minute.
Indocyanine green has recently been proven to be distributed in the serum and excreted into the bile, and the authors show clearly that one can obtain a real-time cholangiogram during laparoscopic surgery. I don't routinely do cholangiograms anymore—for a variety of reasons I have migrated to the selective approach—but I am tempted to start using this simple noninvasive technique again.
The clinical use of in vivo visualization with indocyanine green is rapidly evolving. It has been shown to be useful for sentinel node biopsies in breast cancer,1 and it may be helpful in visualization of sentinel nodes in gastric and colorectal cancers.
Welcome to the new world of publishing. While a picture may be worth a thousand words, videos solidify one's understanding of a described observation; you are really looking through the author's eyes. In our discipline, videos change the way we do things by simply showing you what to do and how to do it. The major surgical societies now have video libraries, and journals need to promote videos as part of manuscripts. Basic science journals such as Science have had videos for years—of birds, axonal transmission, and molecular pathways—as supplemental material, so it makes sense to actually show operative videos of new surgical approaches.
The Archives journals have embraced videos, and I am happy to help facilitate our journal's publication of these as your Web Editor.
Videos can be submitted as part of a manuscript, as a case report (as it is this month), or as an "Image of the Month." I would like to ask those of you who have old movies that were presented at meetings in the past to consider formatting them into a 5-minute video and submitting them for peer review. There have been hundreds of such videos presented at meetings in the past, and I think they are a treasure trove of ideas, helpful hints, techniques, and reminders that would benefit surgeons all over the world.
OUR WEBSITE
Archives of Surgery has a very active, and interactive, Web site. Our experienced progressive staff are keeping us at the cutting edge of publishing. Visit our Web site (www.archsurg.com) and look around! There is a lot of stuff to do. A quick glance reveals many free features. The "Table of Contents" is of course free, as are any research articles 12 months after their date of publication.
Below the "Current Issue" content on the home page is "Top Content," which has links to our articles that have been viewed and e-mailed the most. In that section, too, is the "Most Viewed Collections." In these collections are Archives of Surgery articles sorted by topic. For example, the collection "Neurology" includes articles on carotid surgery, postoperative delirium, and stroke after aortic surgery. Under "Infectious Disease" are articles on surgical sepsis, antibiotic prophylaxis, and liver transplants for hepatitis.
Conversely, under the "Topic Collections" link at the top of the page, you can view articles published in Archives of Surgery or across the Archives family of journals from 1998 to the present on topics like hepatobiliary surgery, pancreas transplantation, or geriatrics. You can even subscribe for e-mail alerts on new articles regarding specific topics.
Here are a couple of ideas to get started: first, sign up for free monthly e-mail alerts in which are embedded the "Table of Contents." Hyperlinks are offered for each article and their accompanying commentaries. If you are an individual subscriber (or American Medical Association [AMA] member), you can store articles that interest you in "My Folder." Second, have fun with the continuing medical education (CME) section. This is true case-based learning. Expertly edited by Edward E. Cornwell, MD, selected papers are dissected into portions that are particular to the disease itself and issues particular to the paper. The quizzes given online, available to individual subscribers and AMA members, are akin to open-book tests, and the simple exercise of going through the questions is a valuable learning process. If you take one test, you will learn a lot.
Third, use the PowerPoint utility offered in our articles. In any article you view as full text, each table or figure can be viewed and saved as a PowerPoint slide. Rather than copying/pasting the image and manually entering references into your slide, you can directly import the image to a presentation along with the citation and caption and use it as a teaching tool.
Fourth, look at the right panel on the Web site. There you will often find advertisements for JAMA-related features and publications, including JAMAevidence and Author in the Room. These offer audio interviews and teleconferences that can be downloaded and listened to as MP3 files or subscribed to as podcasts. Okay, it isn't all surgery, but it is high-impact state-of-the-art medicine.
Fifth, enjoy the online "Image of the Month." Taken right out of the journal, you can test your knowledge of both the obvious and obscure. Here is a trick: if you go to "Most Viewed Collections" and click "Diagnosis," you can review "Images of the Month" from the past few years.
Sixth, under "Stay Connected," our Web site allows you to plug real simple syndication (RSS) feeds of Archives journals into your personal homepage. It also has hyperlinks to calendars of national courses and a link to JAMA's CareerNet, which posts advertisements of job opportunities.
Many of these features are linked to your paid subscription; you just need to activate the feature online. But to serve countries with health care needs that cannot afford subscriptions, Archives and the JAMA family of journals participate in the World Health Organization's Health InterNetwork Access to Research Initiative (HINARI) program. The full text of JAMA is also available to institutions with the Access to Global Online Research in Agriculture (AGORA) program.
THE FUTURE
The real excitement is to come. If you go to "Past Issues," you will note that full-text "Backfiles of Archives of Surgery" are coming, from all the way back to its inaugural year of 1929. While research articles from 1998 through 1 year after publication are free, there will be an extra charge for access to the "Backfiles" articles (which individuals can purchase via pay per view); I suspect most libraries will ultimately subscribe to this service.
Lastly, in the near future Archives will be participating in the HighWire 2.0 project. A nonprofit company run out of the Stanford University library, HighWire is the Web host for many high-impact peer-reviewed journals. The new H20 platform will facilitate better coordination with Web-based services such as RSS feeds, widgets, social bookmarking, and other enhanced Web services.
So stay connected to Archives of Surgery. Start by subscribing to our monthly e-mail, look at the online images, and take the interactive CME tests. Think about submitting videos that would be of interest to our readership, even some classic great operations that were presented at national meetings that are still on film. Stay with us for a nice trip into the electronic future.
AUTHOR INFORMATION
Correspondence: Dr Zenilman, State University of New York Downstate Medical Center, Department of Surgery, Box 40, 450 Clarkson Ave, Brooklyn, NY 11203 (mzenilman{at}downstate.edu).
Financial Disclosure: None reported.
