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A novel interface for the telementoring of robotic surgery
Author(s) -
Shin Daniel H.,
Dalag Leonard,
Azhar Raed A.,
Santomauro Michael,
Satkunasivam Raj,
Metcalfe Charles,
Dunn Matthew,
Berger Andre,
Djaladat Hooman,
Nguyen Mike,
Desai Mihir M.,
Aron Monish,
Gill Inderbir S.,
Hung Andrew J.
Publication year - 2015
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12985
Subject(s) - perioperative , significant difference , medicine , interface (matter) , statistical analysis , computer science , multimedia , surgery , operating system , bubble , maximum bubble pressure method , statistics , mathematics
Objective To prospectively evaluate the feasibility and safety of a novel, second‐generation telementoring interface ( C onnect ™ ; I ntuitive S urgical I nc., S unnyvale, CA , USA ) for the da V inci robot. Materials and Methods Robotic surgery trainees were mentored during portions of robot‐assisted prostatectomy and renal surgery cases. Cases were assigned as traditional in‐room mentoring or remote mentoring using C onnect. While viewing two‐dimensional, real‐time video of the surgical field, remote mentors delivered verbal and visual counsel, using two‐way audio and telestration (drawing) capabilities. Perioperative and technical data were recorded. Trainee robotic performance was rated using a validated assessment tool by both mentors and trainees. The mentoring interface was rated using a multi‐factorial L ikert‐based survey. The M ann– W hitney and t ‐tests were used to determine statistical differences. Results We enrolled 55 mentored surgical cases (29 in‐room, 26 remote). Perioperative variables of operative time and blood loss were similar between in‐room and remote mentored cases. Robotic skills assessment showed no significant difference ( P > 0.05). Mentors preferred remote over in‐room telestration ( P = 0.05); otherwise no significant difference existed in evaluation of the interfaces. Remote cases using wired (vs wireless) connections had lower latency and better data transfer ( P = 0.005). Three of 18 (17%) wireless sessions were disrupted; one was converted to wired, one continued after restarting C onnect, and the third was aborted. A bipolar injury to the colon occurred during one (3%) in‐room mentored case; no intraoperative injuries were reported during remote sessions. Conclusion In a tightly controlled environment, the C onnect interface allows trainee robotic surgeons to be telementored in a safe and effective manner while performing basic surgical techniques. Significant steps remain prior to widespread use of this technology.