title: Long distance telementoring. A novel tool for laparoscopy aboard the USS Abraham Lincoln.
abstract: BACKGROUND
  As general surgeons perform a growing number of laparoscopic operations in increasingly specialized environments, the ability to obtain expert advice during procedures becomes more important. Technological advances in video and computer communications are enabling surgeons to procure expertise quickly and efficiently. In this article, we present laparoscopic procedures completed through an intercontinental telementoring system and the first telementored laparoscopic procedures performed aboard a naval vessel.
  
  
  METHODS
  Video, voice, and data streams were linked between the USS Abraham Lincoln Aircraft Carrier Battlegroup cruising the Pacific Ocean and locations in Maryland and California, creating the Battlegroup Telemedicine (BGTM) system. Three modes of BGTM communication were used: intraship, ship to ship, and ship to shore.
  
  
  RESULTS
  Five laparoscopic inguinal hernia repairs were completed aboard the Lincoln under telementoring guidance from land-based surgeons thousands of miles away. In addition, the BGTM system proved invaluable in obtaining timely expertise on a wide variety of surgical and medical problems that would otherwise have required a shore visit.
  
  
  CONCLUSIONS
  Successful intercontinental laparoscopic telementoring aboard a naval vessel was accomplished using "off-the-shelf" components. In many instances, the high risk and cost of transporting patients to land-based facilities was averted because of the BGTM system. Also, the relationship between the on-site and telementoring surgeon was critical to the success of this experiment. Long-distance telementoring is an invaluable tool in providing instantly available expertise during laparoscopic procedures.
authors.affiliation: United States Naval Hospital, 2080 Childs Street, Jacksonville, FL 32214-0324, USA.
authors.forename: M
authors.initials: M
authors.lastname: Cubano
authors.forename: B K
authors.initials: BK
authors.lastname: Poulose
authors.forename: M A
authors.initials: MA
authors.lastname: Talamini
authors.forename: R
authors.initials: R
authors.lastname: Stewart
authors.forename: L E
authors.initials: LE
authors.lastname: Antosek
authors.forename: R
authors.initials: R
authors.lastname: Lentz
authors.forename: R
authors.initials: R
authors.lastname: Nibe
authors.forename: M F
authors.initials: MF
authors.lastname: Kutka
authors.forename: M
authors.initials: M
authors.lastname: Mendoza-Sagaon
mesh_terms: D000328:Adult; D005069:Evaluation Studies as Topic; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008889:Military Personnel; D012767:Ships; D017216:Telemedicine / Q000379:methods*