The personal digital assistant (PDA) as a tool for telementoring endoscopic procedures.

The telementoring of surgical procedures is currently achieved via a wired infrastructure that usually requires sophisticated videoconference systems. This project represents the first step in assessing the potential for using handheld computers as a mobile alternative to current telementoring systems. Specifically, this project compares a handheld computer to a standard CRT monitor regarding their capability to accurately display video images from an endoscopic procedure. Video images from two previously recorded endoscopic procedures were transmitted from a standard VCR to: 1) a handheld computer (iPAQ 3670 running Pocket PC) via a wireless LAN and 2) a standard CRT monitor via a wired analog connection. The software-used on the handheld device was custom designed to allow 320 X 240 pixel video images to be broadcast in real time. Twenty-three surgical residents who had completed an endoscopy rotation were randomized to watch one of the two videotaped endoscopic procedures on the hand held computer or on the CRT monitor. After viewing the procedure, a ten-question quiz was used to assess the ability of each participant to recognize several anatomic landmarks. The result of each questionnaire was expressed as the percentage of correct responses. Using a crossover design, each participant then viewed the other videotaped procedure using the alternate device and completed a second quiz. The mean test score for each device was calculated, and these data was analyzed using a Student T test. The observed difference between the mean test score associated with the handheld device (77.93 +/- 11.26) and the CRT monitor (81.30 +/- 12.54) was not statistically significant (p<0.41). In addition, regardless of the device used, scores corresponding to video tape one were significantly higher than those recorded for video tape two (84.35 +/- 9.92 vs. 74.35 +/- 11.61; p < 0.01) All participants were able to recognize anatomic landmarks equally well when viewing broadcasted endoscopic procedures on a handheld display or a standard CRT monitor. Handheld computers may have a role in telementoring residents who are performing endoscopic procedures. Further research is needed to evaluate the integration of handheld devices into telementoring and robotic system to perform surgical procedures.