Teleproctoring in Surgery Training to Avoid Technical Misadventures and Video Recording: Responsibility and Liability

  • Armando Rosales
  • Luis Zorrila-Nunez
  • Emanuele Lo Menzo
  • Raul J. RosenthalEmail author


Sir William Halsted established what is now the basis of modern American surgical training, namely, patient volume and repetition. Due to changes in surgical training, surgeons are now forced to rapidly learn and adapt to new techniques in order to deliver safe care with adequate outcomes.

Introduction of video-based surgical approaches allowed the development of telesurgery, which is defined when an experienced surgeon performs an operation remotely. Significant improvements in communication, laparoscopy, and robotics have allowed expert surgeons or less experienced surgeons to proctor in real-time trainees in remote or underserved areas, or patients who cannot travel for medical care, allowing patients undergoing an operation through a minimally invasive approach benefiting patients with a faster recovery and cost reductions.

In telesurgery, the proctor and mentored surgeon should define in writing his/her roles to the patient. There are still ongoing debates about the proctor’s responsibility when substandard care and patient care responsibilities are delivered, and if an emergency occurs, legal immunity has been proposed for proctors.

Despite multiple challenges, advances in technology and telecommunication, telemedicine, and telementoring are an integral part of the development and evaluation of surgical motor skills.


Teleproctoring Telesurgery Telementoring Surgery training Video recording 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Armando Rosales
    • 1
  • Luis Zorrila-Nunez
    • 1
  • Emanuele Lo Menzo
    • 2
  • Raul J. Rosenthal
    • 3
    Email author
  1. 1.Department of General SurgeryCleveland Clinic FloridaWestonUSA
  2. 2.Department of Research, Department of General SurgeryCleveland Clinic FloridaWestonUSA
  3. 3.The Metabolic and Bariatric Institute, Department of General SurgeryCleveland Clinic FloridaWestonUSA

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