Telementoring.

Telementoring began in the 1950s and is an advanced application of telemedicine that involves the removed guidance of a procedure where the student has no or limited experience. In the past 10 to 15 years, telemedicine has been revisited as a result of the healthcare delivery crisis, budgetary concerns, and the impact of managed care. In recent years, telementoring has had a number of successes which have led to further recent telementoring investigations and developments. Telementoring programs were established because it was impractical for specialized minimally invasive surgeons to proctor fellow surgeons during the adoption phase of new techniques. This catalyzed the establishment of formal telementoring procedural guidelines and networks. Efforts have been made in the remote direction of laparoscopic spermatic vein ligations, renal biopsy, nephrectomy, varicocelectomy, fetoscopy, and ophthalmology. Pilot studies in 2000 have statistically validated that telementoring can be as effective as on-site mentoring. In order to successfully conduct telementoring missions, however, it is important to follow a precise algorithm. If a standardized protocol is followed, it will ensure that telementoring is practiced safely and efficiently.