# Surgical headlamp



## jack_harbor (Jan 18, 2017)

Hello everyone,

I'm a surgical resident (read: poor) and am looking to purchase an adequate headlight to wear while operating. I wear loupes, so the light has to be fairly bright. Traditionally, surgeons wear fiber-optic headlamps mounted on a bulky "halo" as they call them, with an fiber optic cable that you clip to your gown/scrubs and attach to a large xenon light source (here's an example: http://sunoptictech.com/sunoptic-surgical-products/). These are very bright and the hospital has them lying around, but, as you can imagine, having a cord attached to your head is somewhat inconvenient. In addition, the halo is somewhat heavy, which combined with the weight of loupes and bending your neck downwards for 12-18 hours straight can contribute to a fair amount of neck pain and headaches.

More recently, companies have developed portable, battery operated LED surgical headlamps (example: https://www.designsforvision.com/SurgHtml/LED/S-Lights.htm). They aren't nearly as bright as their fiber optic counterparts and the light field isn't as large or uniform, but the convenience of being cordless and their lightweight makes them worth their shortcomings.

Unfortunately, all of the surgical LED headlamps are outrageously expensive (around $1000 or more for base models). I suspect this price is a reflection of them being sold to the medical market (1000% markup) and not a reflection of the cost of these systems, which brings me to my question:

Does anyone know of a headlamp solution that would work for a surgeon? The requirements would be that it is as bright as possible, has a narrowly focused beam of light (3-4" circle at a distance of 12-18" from the head), battery operated with interchangeable (and preferably rechargeable) battery packs than can be worn on the waist (not on the headband if possible) as it would be used continuously for 12-18 hours, lightweight, and preferably cheap! Being small enough to be mounted directly to a pair of loupes (avoiding the need for a headband) would be a major plus.

I've got a BlackDiamond Icon headlamp (http://blackdiamondequipment.com/en_US/headlamps-and-lanterns/icon-headlamp-BD620617ALUMALL1.html) which I use for camping, and have tried this in the operating room, but it isn't quite bright enough and the beam is designed more for maximum brightness at a distance much greater than needed for operating.

Does anyone have any suggestions? Perhaps building something myself or altering an existing headlamp with different optics to focus the beam would be an option?

Much appreciated!


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## KITROBASKIN (Jan 18, 2017)

Seems like color rendering would be very important. Just wondering if the use of 'non medical' illumination devices might complicate liability should something go wrong, lawyers being lawyers.


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## firsttothescene (Jan 18, 2017)

KITROBASKIN said:


> Seems like color rendering would be very important. Just wondering if the use of 'non medical' illumination devices might complicate liability should something go wrong, lawyers being lawyers.


+1


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## vadimax (Jan 18, 2017)

KITROBASKIN said:


> Seems like color rendering would be very important. Just wondering if the use of 'non medical' illumination devices might complicate liability should something go wrong, lawyers being lawyers.



I guess his patients do not complain


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## Jomohr84 (Jan 18, 2017)

Lol! There are probably some decent options, not sure about the waist mountable battery part though. Definitely check into whether there is a liability issue before spending your money though, or you may be stuck with a headlamp that you can't even use.


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## jack_harbor (Jan 18, 2017)

KITROBASKIN said:


> Seems like color rendering would be very important. Just wondering if the use of 'non medical' illumination devices might complicate liability should something go wrong, lawyers being lawyers.



Liability shouldn't be an issue. The FDA regulates only devices being used on patients to perform a treatment. A light is the surgeons preference, and some surgeons don't use them at all. As for color rendering, the ideal color temperature for tissue visualization is approximately 5800 K, but this is also surgeon preference. Many of the ceiling mounted operating room lights have adjustable color temperatures, with younger surgeons favoring a brighter, white light. Some of older surgeons prefer a yellower light, to mimic the incandescent bulbs they used "back in the good old days".


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## dwong (Jan 18, 2017)

Most medical lighting got some kind of regulation, depending on usage/location.
Even the 2 links you provided showing:



*Classification*


European Class I, Active device per Annex IX, rule 1
FDA Class I, Device Listing 125713
Complies with Essentials Requirements Matrix of MDD 93/42/EEC, amended by 2007/47/CE
*Approved for use in the O.R.,* IEC 60601, CE, ETL Canada and US

I suggest you don't take any chance with career, double check with safety compliance guy at your hospital/facilities. 





jack_harbor said:


> Liability shouldn't be an issue. The FDA regulates only devices being used on patients to perform a treatment. A light is the surgeons preference, and some surgeons don't use them at all. As for color rendering, the ideal color temperature for tissue visualization is approximately 5800 K, but this is also surgeon preference. Many of the ceiling mounted operating room lights have adjustable color temperatures, with younger surgeons favoring a brighter, white light. Some of older surgeons prefer a yellower light, to mimic the incandescent bulbs they used "back in the good old days".


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## iamlucky13 (Jan 18, 2017)

This is a question I wish I could answer, as I have a relative who is an equine vet. He has an older Enova LED surgical headlamp he spent a fortunte on that he thinks is starting to wear out after years of hard use. He tried a headlamp from REI, and felt it wasn't even close to what he needed.

Most of the outdoors headlamps on the market have varying degrees of spill outside their central beam, or are even flood beams. They're designed to light up wide areas of a campsite, not small work zones for surgery.

When I've tried to learn more about medical headlamps for my relative's benefit, I've gotten the impression that this spill is undesired because you want light concentrated down in the surgical opening, not so much on surrounding area where it can make your eyes adjust to the light level outside the surgical opening.

It sounds like perhaps your Black Diamond gave you similar trouble, although you describe it different than I do?

Also, many of the nicer outdoors headlamps have non-centered lenses to make more room for cylindrical batteries. Some also have knurling or other textures that may be difficult to clean (I don't know how critical that is for objects that don't touch the patient, but you might touch with a clean hand). Almost all of them have elastic headbands for portability and weight savings.

All of the medical and dental headlamps I've seen have centered lenses, and their position up/down is usually adjustable so you can get the light beam more in line with your eyes when necessary to minimize shadows. Surface textures and presence of recesses that may be hard to clean varies. Headbands are almost always rigid plastic for maximum support and ease of putting on one-handed.

Does this sound right to you, or do you have anything more to add?

One I'm considering trying for a gift for the relative is the Fenix HP30. It has the highest intensity spec for the beam I've found, and uses 2 x 18650 batteries for long runtime. The batteries can mount to the back of the headband or with an extension cord clipped to a belt or stuffed in a pocket.

Fenix says it will produce 13538 candela maximum light intensity in the center of the beam in turbo. A converter I found (Link) says that should equal 82000 lux at 16 inches. On high mode, that would be about 45,000 lux. With high capacity batteries, it can run on high for almost 4 hours (expect the light output to dim significantly towards the end). There are five discrete brightness modes, and an adjustable elastic headband that holds the emitter in the center of your forehead. Color temperature and CRI are not stated, but I've seen it described as cool white.

One of candlepowerforums' highly respected users wrote a detailed test and review of it here:
http://www.candlepowerforums.com/vb...123A)-Headlamp-Review-RUNTIMES-BEAMSHOTS-more!

The SSL 9000 battery powered surgical LED headlamp I found in the link you provided says it can provide 43000 lux at 16 inches for 2 hours, 45 minutes. It looks like brightness can be infinitely varied with a dial. The headband is rigid, and it looks like the lens can be lowered far enough to put it more or less directly between your eyes if desired. Color temperature is specified at 4500K (neutral white).

So, it sounds like the Fenix might be in the right ballpark, although perhaps not a perfect replacement for a purpose-designed surgical headlamp. If you happen to give it a try, or find something better, I'd appreciate if you share your experience here.


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## scs (Jan 18, 2017)

Any helpful stuff in here?

http://www.candlepowerforums.com/vb/showthread.php?403049-Surgical-Headlamp-please-help

http://www.candlepowerforums.com/vb/showthread.php?273580-Best-headlamp-for-surgery

http://www.candlepowerforums.com/vb/showthread.php?298785-Need-recommendation-for-surgical-headlamp


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## eh4 (Jan 21, 2017)

I think that a custom light based upon the cheap "Zooming" focal heads is what's needed. 
The zoom feature could have a screw-knob or cam lock, -or not. 
High CRI emitter around 5500-6000k as OP described, and a better heat sink if necessary. 
Run a bunch of 18650 in parallel in a fanny pack.


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## okent (Jan 22, 2017)

I am an ENT surgeon and have been looking for a fix for this since I started my residency in 1999(read poor as well, halogen headlamps were about $600 at that time). This was right at the forefront of high output LED's. Luxeon had just come out with their first iterations and I emailed them about info. They sent me a sample! I built my own headlamps for quite a few years by cutting off the head unit of the Browning dual AA headlamp (which is now owned by Pelican) and patching on a Luxeon emitter with optics and a driver.
I now use a Fenix MC11 flipped upside down and it's about a bulletproof as it gets. Bright enough to operate with and super light. Only takes 1 AA. Run time is 4 hours plus on medium. I don't like having a light so bright that when I look away from operative field my vision is washed out.
I use it in my office daily and small enough to drop in my pocket while on rounds. I am the program director for an ENT residency and buy one for each of my new residents.(They're about 35 bucks)

The only thing I wish was an option is exactly what you mentioned: Adjustable focus. 
I still haven't given up on making another version with focus but finding an ultra narrow optic (1-2 degree would be best) has been impossible for me.
There are optic combinations that will do this but my feeling is that it could be no wider than 1" in diameter and 1.5" long.
With work and life and the MC11 I just haven't had the desire to push toward a new design until recently. 
It's back on my list.
If you'd like to visit about this PM me and we can talk more offline.

Tom


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