title: Telementoring of laparoscopic procedures: initial clinical experience.
abstract: BACKGROUND
  To assess the feasibility of telementoring, a clinical telepresence system was developed.
  
  
  METHODS
  Telementoring was attempted in 14 advanced and 9 basic urologic laparoscopic procedures. The remote surgeon located in a control room (> 1,000 feet from operating room) supervised an inexperienced surgeon. Mentoring was accomplished with real-time video images, two-way audio communication, a robotic arm used to control the videoendoscope, and a telestrator. The patient outcome, complications, and operative time were assessed and compared to patients undergoing matched procedures in which the experienced surgeon was working side by side with the primary surgeon.
  
  
  RESULTS
  The overall telementoring success rate was 95.6% (22/23 cases) with no increase in complications. Telementoring of a laparoscopic radical nephrectomy failed secondary to improper positioning of the robotic arm. Operative times compared between telementored and traditionally mentored procedures were not statistically different for basic procedures but were longer for advanced cases.
  
  
  CONCLUSIONS
  Telementoring of laparoscopic procedures is safe and feasible. Further clinical studies are needed prior to implementing telementoring in surgical training.
authors.affiliation: The Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD 21224, USA.
authors.forename: R G
authors.initials: RG
authors.lastname: Moore
authors.forename: J B
authors.initials: JB
authors.lastname: Adams
authors.forename: A W
authors.initials: AW
authors.lastname: Partin
authors.forename: S G
authors.initials: SG
authors.lastname: Docimo
authors.forename: L R
authors.initials: LR
authors.lastname: Kavoussi
mesh_terms: D004501:Education, Medical / Q000379:methods; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods; D013685:Telecommunications; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods