What ring tone should be used for patient safety? Early results with a Blackberry-based telementoring safety solution.
OBJECTIVE
Technology currently exists for the application of remote guidance in the laparoscopic operating suite. However, these solutions are costly and require extensive preparation and reconfiguration of current hardware. We propose a solution from existing technology, to send video of laparoscopic cholecystectomy to the Blackberry Pearl device (RIM Waterloo, ON, Canada) for remote guidance purposes. This technology is time- and cost-efficient, as well as reliable.


METHODS
After identification of the critical maneuver during a laparoscopic cholecystectomy as the division of the cystic duct, we captured a segment of video before it's transection. Video was captured using the laparoscopic camera input sent via DVI2USB Solo Frame Grabber (Epiphan Ottawa, Canada) to a video recording application on a laptop. Seven- to 40-second video clips were recorded. The video clip was then converted to an .mp4 file and was uploaded to our server and a link was then sent to the consultant via e-mail. The consultant accessed the file via Blackberry for viewing. After reviewing the video, the consultant was able to confidently comment on the operation.


RESULTS
Approximately 7 to 40 seconds of 10 laparoscopic cholecystectomies were recorded and transferred to the consultant using our method. All 10 video clips were reviewed and deemed adequate for decision making.


CONCLUSIONS
Remote guidance for laparoscopic cholecystectomy with existing technology can be accomplished with relatively low cost and minimal setup. Additional evaluation of our methods will aim to identify reliability, validity, and accuracy. Using our method, other forms of remote guidance may be feasible, such as other laparoscopic procedures, diagnostic ultrasonography, and remote intensive care unit monitoring. In addition, this method of remote guidance may be extended to centers with smaller budgets, allowing ubiquitous use of neighboring consultants and improved safety for our patients.
Department of General Surgery, Henry Ford Hospital, 2799 W. Grand Blvd., Detroit, MI 48202, USA. aparker1@hfhs.org
Alton
A
Parker
Ilan
I
Rubinfeld
Ogochukwu
O
Azuh
Dionne
D
Blyden
Anthony
A
Falvo
Mathilda
M
Horst
Vic
V
Velanovich
Pat
P
Patton
D040421:Cell Phone; D017081:Cholecystectomy, Laparoscopic / Q000592:standards; D006801:Humans; D012449:Safety; D017216:Telemedicine; D020535:Video-Assisted Surgery