Online Live Streaming System for Robotic Surgery With Bidirectional Discussion Through a Commentator: A Multi‐Institutional Observational Study

摘要

INTRODUCTION: Live broadcasting of robot-assisted surgeries has gained traction as a valuable educational tool offering real-time insights into surgical procedures. However, in Japan, legal restrictions and safety concerns have hindered the widespread adoption of live surgery. This study introduces a novel, modified online live-streaming system with a commentator to facilitate bidirectional discussions, addressing these limitations and enhancing surgical education. METHODS: A multi-institutional observational study was conducted using the Intuitive Telepresence system to broadcast da Vinci robotic surgeries. A commentator familiar with the surgeon's style facilitated real-time discussions with remote participants. A questionnaire using a 5-point Likert scale was used to assess usability, surgical comprehension, and bidirectional discussion. Statistical analyses were performed to compare satisfaction levels across different aspects of the system. RESULTS: Between November 2022 and September 2024, six live robotic surgery broadcasts were conducted, with 15 participants attending a total of 19 sessions. Most participants (94.7%) reported positive experiences with the bidirectional discussions, citing the commentator's role as crucial in explaining surgical decisions. The system was highly effective in conveying robotic instrument handling (94.7% rated 4 or higher) and anatomical understanding (94.7%). However, assistant operations and overall operating room dynamics received lower ratings, with 57.9% rating them as unsatisfactory. Early sessions experienced video quality issues, which improved with stable internet connections; later sessions achieved a 90% satisfaction rate. CONCLUSION: Our modified "commentator-based live streaming system" successfully facilitated bidirectional learning and improved robotic surgical education. We aim to expand the use of this live surgical broadcasting system across Japan.