THE USEFULNESS OF EDUCATIONAL TELEMENTORING IN LAPAROSCOPIC SURGERY

The point at which a surgeon subjects a patient to surgery using endoscopic surgical techniques must be preceded by theoretical training and above all practice that are essential for certifying and accrediting the surgeon as fit to perform the surgery. While specialty residencies can the future surgeon with basic practice, learning these techniques requires continuous updating, mainly due to their constant innovation. The biggest challenge of minimally invasive surgery is to attain and maintain adequate standards of quality, which are largely achieved once the learning curve for each type of intervention has been reached. In minimally invasive surgery, education, training and continuous updating essential to ensure that the gradient of the learning curve is less steep.

To accelerate the completion of this learning curve of endoscopic surgical techniques among internal medical residents and on graduate programmes, and to keep specialist endoscopic surgeons updated as regards new techniques, we set out the design of a system to support teaching and surgery with the advantages of ICTs, -based on online telementoring with the main objectives:
1. To establish a consultancy for training surgeons in rural areas and newly qualified surgeons
2. To implement a continuous and updates mentoring of trained surgeons in laparoscopic surgery , within continuing and postgraduate education
3. To improve the quality of care in endoscopic surgery.

This system uses a secure network and it takes place in two physical spaces: the operating theatre and the location of the mentor providing the Teleservice.

The components of this system are:
a) a real -time video recording format of images captured by the television camera is normally used in an endoscopic surgical intervention;
b ) audio/video communication software (video conferencing) between the operating theatre and the mentor surgeon via a local or open network;
c ) a video camera in the operating theatre;
d) a PC with the mentor surgeon that captures images and sound for video transmission to the operating theatre.

Other items that can be used are:
e ) software enabling the mentor surgeon to overprint various graphics on the image received from the operating theatre for better identification of anatomical structures, surgical times and operative maneuvers,
f) a telescopic arm holding the television camera which can be moved by the mentor surgeon by remote control.

The project is implemented in three phases, with the dual purpose of testing the system and becoming familiar with ICTs (for both the operating surgeons and mentor surgeon) and on gradual basis, first experimentally and then with patients.