Cubano M, Poulose B K, Talamini M A, Stewart R, Antosek L E, Lentz R, Nibe R, Kutka M F, Mendoza-Sagaon M
United States Naval Hospital, 2080 Childs Street, Jacksonville, FL 32214-0324, USA.
Surg Endosc. 1999 Jul;13(7):673-8. doi: 10.1007/s004649901071.
As general surgeons perform a growing number of laparoscopic operations in increasingly specialized environments, the ability to obtain expert advice during procedures becomes more important. Technological advances in video and computer communications are enabling surgeons to procure expertise quickly and efficiently. In this article, we present laparoscopic procedures completed through an intercontinental telementoring system and the first telementored laparoscopic procedures performed aboard a naval vessel.
Video, voice, and data streams were linked between the USS Abraham Lincoln Aircraft Carrier Battlegroup cruising the Pacific Ocean and locations in Maryland and California, creating the Battlegroup Telemedicine (BGTM) system. Three modes of BGTM communication were used: intraship, ship to ship, and ship to shore.
Five laparoscopic inguinal hernia repairs were completed aboard the Lincoln under telementoring guidance from land-based surgeons thousands of miles away. In addition, the BGTM system proved invaluable in obtaining timely expertise on a wide variety of surgical and medical problems that would otherwise have required a shore visit.
Successful intercontinental laparoscopic telementoring aboard a naval vessel was accomplished using "off-the-shelf" components. In many instances, the high risk and cost of transporting patients to land-based facilities was averted because of the BGTM system. Also, the relationship between the on-site and telementoring surgeon was critical to the success of this experiment. Long-distance telementoring is an invaluable tool in providing instantly available expertise during laparoscopic procedures.
随着普通外科医生在越来越专业化的环境中进行越来越多的腹腔镜手术，在手术过程中获得专家建议的能力变得更加重要。视频和计算机通信技术的进步使外科医生能够快速有效地获取专业知识。在本文中，我们展示了通过洲际远程指导系统完成的腹腔镜手术以及在海军舰艇上进行的首例远程指导腹腔镜手术。
在太平洋巡航的亚伯拉罕·林肯号航空母舰战斗群与马里兰州和加利福尼亚州的地点之间建立了视频、语音和数据流连接，创建了战斗群远程医疗（BGTM）系统。使用了BGTM的三种通信模式：舰内、舰对舰和舰对岸。
在数千英里外的陆基外科医生的远程指导下，林肯号上完成了5例腹腔镜腹股沟疝修补术。此外，BGTM系统在获取各种外科和医疗问题的及时专业知识方面被证明具有极高价值，否则这些问题需要靠岸就诊。
使用“现成”组件在海军舰艇上成功实现了洲际腹腔镜远程指导。在许多情况下，由于BGTM系统，避免了将患者转运至陆基设施的高风险和高成本。此外，现场外科医生与远程指导外科医生之间的关系对本实验的成功至关重要。远程指导是在腹腔镜手术期间提供即时可用专业知识的宝贵工具。
