Abstract:

Background:
Telementoring as a system for remote guidance or online technical assistance has been developed as a telemedicine system capable of providing both online and recorded support and training in surgical techniques

Purposes:
This study proposes the design of a system for teaching, mentoring and surgical support using Information and Communications Technology for robotic bariatric surgery

Methods:
A system of telementoring was established between an university center and one hospital of the same health administrative area with few experience in robotic bariatric surgery (learning curve less than 50%). Telementoring was performed via internet protocol using a direct point-to-point connection with added security with advanced encryption standard (AES). In the period of one year (June 2014 to June 2015), all interventions for robotic bariatric surgery (sleeve gastrectomy and gastric bypass) were included. When patients agree with telementoring, data outcomes at point of care for these robotic bariatric procedures (total operating time -preparation and intervention-, hospital stay, conversion to open surgery and morbility) were collected. The rest of these interventions without agreement to robotic surgery were performed by the same surgeons. Data were analyzed statistically using appropriate tests.

Results:
In the period selected , 24 patients underwent robotic bariatric surgery, 18 of whom were referred and accepted for telementoring during surgery. Patients selected without telementoring took longer: 220 (66) min vs 168 (46) min, p < 0.01. The hospital stay were median 3.6 (0.5) days for telementored interventions and median 5.7 (0.5) days without mentoring (p < 0.01). Three patients in non mentored groups suffered minor complications.

Conclusions:
This program supports the safety and feasibility of telementoring in robotic bariatric surgery in surgeons with difficulties for teaching alternatives in their learning curves.

Keywords:

Robotic Bariatric Surgery, Image-guided Procedures, Learning Curve, Minimally Invasive Procedures, Operating Room Technology, Surgical Eucation.