Snyderman Carl H, Gardner Paul A, Lanisnik Bostjan, Ravnik Janez
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Laryngoscope. 2016 Jun;126(6):1334-8. doi: 10.1002/lary.25753. Epub 2016 Mar 24.
OBJECTIVES/HYPOTHESIS: To assess the efficacy of a surgical telementoring program for endoscopic skull base surgery.
Prospective case series with surveys of surgeons.
A surgical telementoring program was established for mentoring of a skull base team at the University of Maribor in Slovenia by an experienced skull base team at the University of Pittsburgh Medical Center in Pennsylvania. Two-way video and audio streaming provided real-time communication with the surgical team. Over a period of 3 years, 10 endoscopic endonasal surgeries of the skull base were mentored preoperatively and during the key part of the procedure. Following each procedure, an evaluation form was used to document the mentoring interventions and rate the experience.
Procedures included endoscopic endonasal approaches to the sella, anterior cranial fossa, posterior cranial fossa, and orbit. Diagnoses included benign and malignant neoplasms, cerebrospinal fluid leak, and inflammatory disease. In nine of 10 cases, adequate audio and video communications were maintained. The most frequent mentoring interventions were for identification of anatomy, extent of exposure, extent of resection, and surgical technique. The median perceived value by the junior surgical team was 9.5 (range 8-10). A model for surgical telementoring is proposed.
Surgical telementoring provides the ability to help surgeons develop their surgical skills to a greater level of proficiency for complex surgeries when experienced mentors are not available locally. The technology is reliable and available at most institutions. Perceived benefits of surgical telementoring include improved surgical exposure, increased extent of tumor resection, and decreased duration of surgery.
N/A. Laryngoscope, 126:1334-1338, 2016.
目的/假设:评估用于内镜颅底手术的外科远程指导项目的疗效。
对外科医生进行调查的前瞻性病例系列研究。
建立了一个外科远程指导项目,由宾夕法尼亚州匹兹堡大学医学中心经验丰富的颅底团队指导斯洛文尼亚马里博尔大学的一个颅底团队。双向视频和音频流实现了与手术团队的实时通信。在3年的时间里,对10例内镜鼻内颅底手术进行了术前及手术关键部分的指导。每例手术后,使用一份评估表记录指导干预措施并对体验进行评分。
手术包括经鼻内镜入路至鞍区、前颅窝、后颅窝和眼眶。诊断包括良性和恶性肿瘤、脑脊液漏和炎症性疾病。10例中有9例维持了足够的音频和视频通信。最常见的指导干预措施是解剖结构识别、暴露范围、切除范围和手术技术。初级手术团队感知到的价值中位数为9.5(范围8 - 10)。提出了一个外科远程指导模型。
当当地没有经验丰富的指导者时,外科远程指导能够帮助外科医生将其手术技能提升到更熟练的水平以进行复杂手术。该技术可靠且大多数机构都可使用。外科远程指导的感知益处包括改善手术暴露、增加肿瘤切除范围和缩短手术时间。
无。《喉镜》,2016年,第126卷,第1334 - 1338页