International surgical telementoring: Our initial experience

Introduction: Telesurgical laparoscopic telementoring has successfully been implemented between the Johns Hopkins Bayview Medical Center and the Johns Hopkins Hospital in 27 prior operations. In this previously reported series, telerobotic mentoring was achieved between two institutions 3.5 miles away. We report our experience in performing two international surgical telementoring operations. Purpose: To determine the clinical utility of international surgical telementoring during laparoscopic surgical procedures. Method: A laparoscopic adrenalectomy was telementored between Innsbruck, Austria (5,083 miles) and Baltimore, MD. As well, a laparoscopic varicocelectomy was telementored between Bangkok, Thailand and Baltimore, MD (10,880 miles) both over three ISDN lines (384 kbps) with an approximate 1 sec delay. Results: Both procedures were successfully accomplished with an uneventful postoperative course. Conclusion: International telementoring is a viable method of instructing less experienced laparoscopic surgeons through potentially complex laparoscopic procedures, as well as potentially improving patient access to specialty care.