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Telementoring and Telesurgery for Minimally Invasive Procedures.

Publication ,  Journal Article
Hung, AJ; Chen, J; Shah, A; Gill, IS
Published in: J Urol
February 2018

PURPOSE: Tremendous interest and need lie at the intersection of telemedicine and minimally invasive surgery. Robotics provides an ideal environment for surgical telementoring and telesurgery given its endoscopic optics and mechanized instrument movement. We review the present status, current challenges and future promise of telemedicine in endoscopic and minimally invasive surgery with a focus on urological applications. MATERIALS AND METHODS: Two paired investigators screened PubMed®, Scopus® and Web of Science® databases for all full text English language articles published between 1995 and 2016 using the key words "telemedicine," "minimally invasive surgical procedure," "robotic surgical procedure," "education" and "distance." We categorized and included studies of level of interaction between proctors and trainees. Research design, special equipment, telecommunication network bandwidth and research outcomes of each study were ascertained and analyzed. RESULTS: Of 65 identified reports 38 peer-reviewed studies qualified for inclusion. Series were categorized into 4 advancing levels, ie verbal guidance, guidance with telestration, guidance with tele-assist and telesurgery. More advanced levels of surgical telementoring provide more effective and experiential teaching but are associated with increased telecommunication network bandwidth requirements and expenses. Concerns regarding patient safety and legal, financial, economic and ethical issues remain to be reconciled. CONCLUSIONS: Telementoring and telesurgery in minimally invasive surgery are becoming more practical and cost effective in facilitating teaching of advanced surgical skills worldwide and delivery of surgical care to underserved areas, yet many challenges remain. Maturity of these modalities depends on financial incentives, favorable legislation and collaboration with cybersecurity experts to ensure safety and cost-effectiveness.

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Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

February 2018

Volume

199

Issue

2

Start / End Page

355 / 369

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urologic Surgical Procedures
  • United States
  • Telemedicine
  • Robotic Surgical Procedures
  • Minimally Invasive Surgical Procedures
  • Mentoring
  • Humans
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Hung, A. J., Chen, J., Shah, A., & Gill, I. S. (2018). Telementoring and Telesurgery for Minimally Invasive Procedures. J Urol, 199(2), 355–369. https://doi.org/10.1016/j.juro.2017.06.082
Hung, Andrew J., Jian Chen, Ankeet Shah, and Inderbir S. Gill. “Telementoring and Telesurgery for Minimally Invasive Procedures.J Urol 199, no. 2 (February 2018): 355–69. https://doi.org/10.1016/j.juro.2017.06.082.
Hung AJ, Chen J, Shah A, Gill IS. Telementoring and Telesurgery for Minimally Invasive Procedures. J Urol. 2018 Feb;199(2):355–69.
Hung, Andrew J., et al. “Telementoring and Telesurgery for Minimally Invasive Procedures.J Urol, vol. 199, no. 2, Feb. 2018, pp. 355–69. Pubmed, doi:10.1016/j.juro.2017.06.082.
Hung AJ, Chen J, Shah A, Gill IS. Telementoring and Telesurgery for Minimally Invasive Procedures. J Urol. 2018 Feb;199(2):355–369.
Journal cover image

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

February 2018

Volume

199

Issue

2

Start / End Page

355 / 369

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urologic Surgical Procedures
  • United States
  • Telemedicine
  • Robotic Surgical Procedures
  • Minimally Invasive Surgical Procedures
  • Mentoring
  • Humans
  • 3202 Clinical sciences
  • 1103 Clinical Sciences