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Telementoring: An Important Enabling Tool for the Community Surgeon

North Bay District Hospital, North Bay; Centre for Minimal Access Surgery, McMaster University, Hamilton, Ontario

Patrick Trudeau, MD

Centre Hospitalier de la Sagamie, Chicoutimi, Québec, Canada

Al Dougall, MD

Susan Hegge, MD

Craig McKinley, MSC EE, MD

North Bay District Hospital, North Bay

Mehran Anvari, MBBS, PhD

Centre for Minimal Access Surgery, McMaster University, Hamilton, Ontario; St. Joseph's Healthcare, 50 Charlton Avenue, East Hamilton, ON L8N 4A6, Canada; anvari{at}mcmaster.ca

This study evaluated the efficacy of telementoring as an enabling tool for community general surgeons to perform advanced laparoscopic surgical procedures. We present a series of 19 patients who underwent advanced laparoscopic surgical procedures in two community hospitals, between November 2002 and July 2003, by four community surgeons with no formal advanced laparoscopic training. Each surgeon was telementored by an expert surgeon from a tertiary care hospital. Telementoring was achieved with real-time two-way audiovideo communications over Internet Protocol or Integrated Services Digital Network lines with bandwidths from 385 kbps to 1.2 mbps. The procedures included 10 bowel resections, 5 Nissen fundoplications, 2 splenectomies, 1 reversal of a Hartmann procedure, and 1 ventral hernia repair. Two of the 19 procedures (11%) were converted to open. There were no intraoperative complications and two postoperative complications (11%). The primary surgeon considered telementoring useful in all cases (median score, 4 of 5). The mentor was also comfortable with the quality of the laparoscopic surgery performed (median score, 4 of 5). Telecommunication bandwidth for audio and video transmission was found to be a critical factor in the quality of telementoring process. Telementoring is safe and feasible. It allows community surgeons with no formal advanced laparoscopic training to benefit from expert intraoperative advice during the performance of advanced laparoscopic procedures. It may also reduce health-care costs by avoiding the need to refer and transfer patients to tertiary care centers.

Key Words: Telementoring • community surgeons • laparoscopic procedures

Surgical Innovation, Vol. 12, No. 4, 327-331 (2005)
DOI: 10.1177/155335060501200407


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