title: Asynchronous confirmation of anatomical landmarks by optical capture in open surgery.
abstract: OBJECTIVE
  Asynchronous remote telementoring and teleproctoring with anatomical subject matter relevant to surgical procedures is an effective instructional tool for surgical trainees.
  
  
  METHODS
  A validation model was established to assess the capabilities of current technologies to conduct effective instruction of surgical procedures in a remote location relative to the actual surgical procedure. A total of 23 unilateral thyroid dissections in 13 patients using a laparoscope affixed to a stationary robotic arm were videotaped. Anatomical confirmation was sought for the superior flap, middle thyroid vein, carotid sheath, 2 parathyroids, inferior thyroidal artery, recurrent laryngeal nerve, and superior thyroid pole.
  
  
  METHODS
  Ten surgical trainees reviewed video segments of these 8 anatomical landmarks at a later time after surgery. During observation of the video segments, these physicians were asked to validate the anatomical landmarks on a survey by choosing concur, do not concur, or uncertain. The review panel was also asked to score the images for quality of light, focus (clarity), field range, and contrast.
  
  
  CONCLUSIONS
  This study validates the use of asynchronous education with high-quality optical capture for distance education and collaboration in open surgery.
authors.affiliation: Medical Informatics and Technology Applications Consortium, Department of Surgery, Virginia Commonwealth University, Richmond 23298, USA.
authors.forename: Azhar
authors.initials: A
authors.lastname: Rafiq
authors.forename: James A
authors.initials: JA
authors.lastname: Moore
authors.forename: Charles R
authors.initials: CR
authors.lastname: Doarn
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Merrell
mesh_terms: D020375:Education, Distance / Q000379:methods*; D013502:General Surgery / Q000193:education*; D006801:Humans; D010535:Laparoscopy; D012371:Robotics / Q000295:instrumentation*; D013959:Thyroid Diseases / Q000601:surgery*; D013961:Thyroid Gland / Q000033:anatomy & histology*; D014743:Videotape Recording