title: A program of telementoring in laparoscopic bariatric surgery.
abstract: BACKGROUND
  This study proposes a system for teaching and surgical support with the benefits of online Information and Communications Technology (ITC) -based telementoring for laparoscopic bariatric surgery (LBS).
  
  
  METHODS
  A system of telementoring was established between a university center and two community hospitals. Telementoring was performed via internet protocol using a direct point-to-point connection, ASDL 1.2 Mbps, time delay 150 ms, 256-bit advanced encryption standard (AES). In the period of time selected, all interventions for LBS in both hospitals were included. When patients agree with telementoring, data outcomes (operating time, hospital stay, conversion to open surgery and complications) were collected. The rest of these interventions were recorded.
  
  
  RESULTS
  Thirty-six patients underwent elective LBS, 20 of whom were referred and accepted for telementoring. Patients selected without telementoring took longer: 200 (46) min vs 139 (33) min, p < 0.01. There were two conversions in non-mentored groups. The hospital stay was 4.6 (0.5) days for telementored interventions and 6.7 (0.5) days without mentoring (p < 0.01). Four patients (12,5%) in non-mentored groups suffered minor complications.
  
  
  CONCLUSIONS
  This program supports the safety and feasibility of telementoring in LBS. Telementoring is an alternative in community hospitals because it can improve the quality of advanced procedures of laparoscopic surgery.
authors.affiliation: a Faculty of Medicine and Health Sciences , Universitat Internacional de Catalunya , Barcelona , Spain .|b Surgical Agrupation of Catalonia and Hospitals , Barcelona , Spain , and.
authors.forename: Fernando
authors.initials: F
authors.lastname: Fuertes-Guiró
authors.affiliation: b Surgical Agrupation of Catalonia and Hospitals , Barcelona , Spain , and.
authors.forename: Enrique
authors.initials: E
authors.lastname: Vitali-Erion
authors.affiliation: c Metropolitan Area CatSalut , Barcelona , Spain.
authors.forename: Amalia
authors.initials: A
authors.lastname: Rodriguez-Franco
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D015992:Body Mass Index; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods; D006764:Hospitals, Community / Q000458:organization & administration; D006785:Hospitals, University / Q000458:organization & administration; D006801:Humans; D020407:Internet; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008611:Mentors; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D012959:Socioeconomic Factors; D013030:Spain; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods*
keywords: Bariatric Surgery; image-guided procedures; learning curve; minimally invasive procedures; operating room technology; surgical education