Summary

We have developed a telesurgery internet platform (SurgTime) that connects the operating room to other surgeons and students regardless of their geographic location and allows real time/live interacting and surgical instruction.

Abstract

Remote surgical education or telesurgery mentoring is the process by which a remote surgeon can in real time interact with the operating surgeon via an accessible, cost-effective communication pathway. Using a telesurgery platform, the remote surgeon can give or receive live virtual assistance from another surgeon over a standard internet connection. Telesurgery can facilitate the collaborative efforts of improving arthroscopic and open surgical teaching methods through visual and audio interactions in the operating room, regardless of geographic boundaries. We have developed a telesurgery internet platform (SurgTime) that connects the operating room to other surgeons and students regardless of their geographic location and allows real time/live interacting and surgical instruction. The purpose of our study is to determine a proof of concept and whether the platform is reliable and if it may have usefulness in teaching arthroscopic shoulder surgical skills and other surgical skills in developing countries. Twelve orthopaedic surgeons from developing countries with an interest in shoulder surgery were recruited for the project. On a bimonthly basis over a period of 18 months, the surgeons were invited to connect via a simple internet connection to the telementoring surgeon in the United States and were able to interact with the telementoring surgeon live during surgery. Using a split screen, the viewing surgeons were able to visualize the same arthroscopic picture that the operating surgeon was seeing and an outside view of the surgical field and were able to ask real time questions during the surgery. There were 30 successful connections from the telementoring surgeon to the mentee surgeons over the 18-month period. There was no loss of connectivity via the telementoring surgeon and the observing surgeons for all 30 cases. There was an average of 3 surgeons viewing each surgical procedure (range 2-5). All the observing surgeons strongly agreed that the system was easy to use, reliable, easy to connect to, and had sufficient image resolution with no significant lag in motion or audio transmission. The observing surgeons and the telementoring surgeon did not feel there were any safety concerns with the procedure, nor did it interfere with the surgical procedure. This internet platform technology allows telesurgery to be performed and transmitted globally to deliver real time/live surgical instruction. This proof of concept found the platform to be efficient, safe and effective as a teaching tool in teaching shoulder arthroscopy. Its successful application in this context has the potential to shape the future of global orthopaedic training in developing countries. By providing real time instruction of surgical instruction from a remote location, telesurgery and telementoring can accelerate the learning curve of doctors in developing countries, enhance knowledge transfer and skill acquisition.