Telerobotic Surgery Is Clinical Reality: Current Experience with Telementoring in Adults and Children

Abstract

A clinical telepresence surgical system was developed at The Johns Hopkins Bayview Hospital. Using both fiberoptic and coaxial cable, a control room located within the hospital was connected to the telepresence operating room. Systems allowing remote surgical teaching included continuous two-way audio communication, real-time laparoscopic and external video imaging, remote telestration, and remote control of a robotic arm designed to manipulate the laparoscope. Using this system, 27 operations were performed in adults and children under the direction of a remote surgical mentor. There were no intraoperative or postoperative complications in this series of cases. All operations were successful. Telementoring was successful in 26 of the 27 cases. In one case, poor positioning of the robotic arm was responsible for a breakdown in the remote surgical teaching process. Operative times for telepresence operations and traditionally mentored cases are compared. In summary, telementoring has proven to be a safe and potentially useful application of telerobotic surgery.