Carl H Snyderman1,2, Paul A Gardner2, Bostjan Lanisnik3, Janez Ravnik4. 1. Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 2. Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 3. Department of Otolaryngology, University of Maribor, Maribor, Slovenia. 4. Department of Neurological Surgery, University of Maribor, Maribor, Slovenia.
Abstract
OBJECTIVES/HYPOTHESIS: To assess the efficacy of a surgical telementoring program for endoscopic skull base surgery. STUDY DESIGN: Prospective case series with surveys of surgeons. METHODS: A surgical telementoring program was established for mentoring of a skull base team at the University of Maribor in Slovenia by an experienced skull base team at the University of Pittsburgh Medical Center in Pennsylvania. Two-way video and audio streaming provided real-time communication with the surgical team. Over a period of 3 years, 10 endoscopic endonasal surgeries of the skull base were mentored preoperatively and during the key part of the procedure. Following each procedure, an evaluation form was used to document the mentoring interventions and rate the experience. RESULTS: Procedures included endoscopic endonasal approaches to the sella, anterior cranial fossa, posterior cranial fossa, and orbit. Diagnoses included benign and malignant neoplasms, cerebrospinal fluid leak, and inflammatory disease. In nine of 10 cases, adequate audio and video communications were maintained. The most frequent mentoring interventions were for identification of anatomy, extent of exposure, extent of resection, and surgical technique. The median perceived value by the junior surgical team was 9.5 (range 8-10). A model for surgical telementoring is proposed. CONCLUSION: Surgical telementoring provides the ability to help surgeons develop their surgical skills to a greater level of proficiency for complex surgeries when experienced mentors are not available locally. The technology is reliable and available at most institutions. Perceived benefits of surgical telementoring include improved surgical exposure, increased extent of tumor resection, and decreased duration of surgery. LEVEL OF EVIDENCE: N/A. Laryngoscope, 126:1334-1338, 2016.
OBJECTIVES/HYPOTHESIS: To assess the efficacy of a surgical telementoring program for endoscopic skull base surgery. STUDY DESIGN: Prospective case series with surveys of surgeons. METHODS: A surgical telementoring program was established for mentoring of a skull base team at the University of Maribor in Slovenia by an experienced skull base team at the University of Pittsburgh Medical Center in Pennsylvania. Two-way video and audio streaming provided real-time communication with the surgical team. Over a period of 3 years, 10 endoscopic endonasal surgeries of the skull base were mentored preoperatively and during the key part of the procedure. Following each procedure, an evaluation form was used to document the mentoring interventions and rate the experience. RESULTS: Procedures included endoscopic endonasal approaches to the sella, anterior cranial fossa, posterior cranial fossa, and orbit. Diagnoses included benign and malignant neoplasms, cerebrospinal fluid leak, and inflammatory disease. In nine of 10 cases, adequate audio and video communications were maintained. The most frequent mentoring interventions were for identification of anatomy, extent of exposure, extent of resection, and surgical technique. The median perceived value by the junior surgical team was 9.5 (range 8-10). A model for surgical telementoring is proposed. CONCLUSION: Surgical telementoring provides the ability to help surgeons develop their surgical skills to a greater level of proficiency for complex surgeries when experienced mentors are not available locally. The technology is reliable and available at most institutions. Perceived benefits of surgical telementoring include improved surgical exposure, increased extent of tumor resection, and decreased duration of surgery. LEVEL OF EVIDENCE: N/A. Laryngoscope, 126:1334-1338, 2016.
Authors: Edgar Rojas-Muñoz; Chengyuan Lin; Natalia Sanchez-Tamayo; Maria Eugenia Cabrera; Daniel Andersen; Voicu Popescu; Juan Antonio Barragan; Ben Zarzaur; Patrick Murphy; Kathryn Anderson; Thomas Douglas; Clare Griffis; Jessica McKee; Andrew W Kirkpatrick; Juan P Wachs Journal: NPJ Digit Med Date: 2020-05-21