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腹腔镜减肥手术的远程指导计划。

A program of telementoring in laparoscopic bariatric surgery.

作者信息

Fuertes-Guiró Fernando, Vitali-Erion Enrique, Rodriguez-Franco Amalia

机构信息

a Faculty of Medicine and Health Sciences , Universitat Internacional de Catalunya , Barcelona , Spain .

b Surgical Agrupation of Catalonia and Hospitals , Barcelona , Spain , and.

出版信息

Minim Invasive Ther Allied Technol. 2016;25(1):8-14. doi: 10.3109/13645706.2015.1083446. Epub 2015 Sep 11.

Abstract

BACKGROUND

This study proposes a system for teaching and surgical support with the benefits of online Information and Communications Technology (ITC) -based telementoring for laparoscopic bariatric surgery (LBS).

MATERIAL AND METHODS

A system of telementoring was established between a university center and two community hospitals. Telementoring was performed via internet protocol using a direct point-to-point connection, ASDL 1.2 Mbps, time delay 150 ms, 256-bit advanced encryption standard (AES). In the period of time selected, all interventions for LBS in both hospitals were included. When patients agree with telementoring, data outcomes (operating time, hospital stay, conversion to open surgery and complications) were collected. The rest of these interventions were recorded.

RESULTS

Thirty-six patients underwent elective LBS, 20 of whom were referred and accepted for telementoring. Patients selected without telementoring took longer: 200 (46) min vs 139 (33) min, p < 0.01. There were two conversions in non-mentored groups. The hospital stay was 4.6 (0.5) days for telementored interventions and 6.7 (0.5) days without mentoring (p < 0.01). Four patients (12,5%) in non-mentored groups suffered minor complications.

CONCLUSIONS

This program supports the safety and feasibility of telementoring in LBS. Telementoring is an alternative in community hospitals because it can improve the quality of advanced procedures of laparoscopic surgery.

摘要

背景

本研究提出了一种用于教学和手术支持的系统,该系统具有基于在线信息通信技术(ITC)的远程指导功能,用于腹腔镜减肥手术(LBS)。

材料与方法

在一所大学中心和两家社区医院之间建立了远程指导系统。通过互联网协议使用直接点对点连接、1.2 Mbps的非对称数字用户线路(ASDL)、150毫秒的时延以及256位高级加密标准(AES)进行远程指导。在选定的时间段内,纳入了两家医院所有的LBS干预措施。当患者同意接受远程指导时,收集数据结果(手术时间、住院时间、转为开放手术和并发症情况)。记录其余这些干预措施。

结果

36例患者接受了择期LBS,其中20例被转诊并接受远程指导。未接受远程指导而选定的患者手术时间更长:200(46)分钟对139(33)分钟,p<0.01。未接受指导的组中有2例转为开放手术。接受远程指导的干预措施的住院时间为4.6(0.5)天,未接受指导的为6.7(0.5)天(p<0.01)。未接受指导的组中有4例患者(12.5%)出现轻微并发症。

结论

该项目支持LBS远程指导的安全性和可行性。远程指导是社区医院的一种选择,因为它可以提高腹腔镜手术高级操作的质量。

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