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A comprehensive review of telementoring applications in laparoscopic general surgery

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Abstract

Background

Incorporation of advanced laparoscopic procedures in the practice of institutions without respective experience is a significant impediment in the dissemination of minimally invasive techniques. On-site mentoring programs carry several cost-related and practical constraints. Telementoring has emerged as a practical and cost-effective alternative mentoring tool. The present study aimed to review the pertinent literature on telementoring applications in laparoscopic general surgery.

Methods

A systematic review using the Medline database was performed. Articles reporting on clinical experience with telementoring applications in general surgery were included. Variations in methodology, study design, and operative procedures precluded cumulative outcome evaluation. Instead, a critical appraisal of current evidence was undertaken.

Results

Seventy-five articles were identified in the primary search, and ten studies were considered eligible. No randomized studies comparing on-site mentoring with telementoring were identified. The included studies reported on a total of 96 laparoscopic telementored procedures: 50 cholecystectomies, 23 colorectal resections, 7 fundoplications, 9 adrenalectomies, 6 hernia repairs, and 2 splenectomies. Completion of remotely assisted procedures was feasible in the vast majority of cases, whereas technical difficulties included video and audio latency with low transfer rates (<128 kbps) and inadequate guidance regarding the correct plane for dissection.

Conclusion

Current evidence supports the feasibility and safety of telementoring programs in general surgery. Their clinical effectiveness as teaching alternatives to traditional mentoring programs remains to be further evaluated.

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Acknowledgments

The authors thank Moji Ghodoussi, PhD, Director Health Enterprise Markets, and Jules Ryckebusch, International Marketing Manager, Stryker Communications, for providing valuable information on technical details of available telementoring systems.

Disclosures

Drs. Stavros A. Antoniou, George A. Antoniou, Jan Franzen, Stefan Bollmann, Oliver O. Koch, Rudolf Pointner, and Frank A. Granderath have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of General and Visceral Surgery, Center for Minimally Invasive Surgery, Hospital “Maria v. d. Aposteln” Neuwerk, Mönchengladbach, Germany

    Stavros A. Antoniou, Jan Franzen, Stefan Bollmann & Frank A. Granderath

  2. Department of Vascular and Endovascular Surgery, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK

    George A. Antoniou

  3. Department of General Surgery, Hospital Zell am See, Zell am See, Austria

    Oliver O. Koch & Rudolf Pointner

  4. Souniou 11, 19001 Keratea Attikis, Athens, Greece

    Stavros A. Antoniou

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  1. Stavros A. Antoniou
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Correspondence to Stavros A. Antoniou.

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Antoniou, S.A., Antoniou, G.A., Franzen, J. et al. A comprehensive review of telementoring applications in laparoscopic general surgery. Surg Endosc 26, 2111–2116 (2012). https://doi.org/10.1007/s00464-012-2175-x

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  • DOI: https://doi.org/10.1007/s00464-012-2175-x

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