Department of Urology, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124, Modena, Italy.
ORSI Academy, Melle, Belgium.
World J Urol. 2021 Sep;39(9):3465-3471. doi: 10.1007/s00345-021-03594-9. Epub 2021 Feb 4.
Telementoring is one of the applications of telemedicine capable of bringing highly experienced surgeons to areas lacking expertise. In the current study, we aimed to assess a novel telementoring application during the learning curve of transurethral enucleation of the prostate using bipolar energy (TUEB).
A telementoring system was developed by our engineering department. This application was used to mentor ten prospective cases of TUEB performed by an expert endourologist (novice to the TUEB). A questionnaire was filled by the operating surgeon and the mentor to provide subjective evaluation of the telementoring system. Finally, the outcomes of these patients were compared to a control group consisting of ten consecutive patients performed by the mentor.
Ten consecutive TUEB were performed using this telementoring application. Delayed and interrupted connection were experienced in two and one patients, respectively; however, their effect was minor, and they did not compromise the safety of the procedure. None of the patients required conversion to conventional transurethral resection of the prostate. Only one patient in our series experienced grade IIIb complication.
The telementoring application for TUEB is promising. It is a simple and low-cost tool that could be a feasible option to ensure patients' safety during the initial phase of the learning curve without time and locations constraints for both the mentor and the trainee; However, it should be mentioned that telementoring cannot yet replace the traditional surgical training with the mentor and trainee being in the operative room. Further studies are required to confirm the current results.
远程指导是远程医疗的一种应用,它能够将经验丰富的外科医生带到缺乏专业知识的地区。在目前的研究中,我们旨在评估一种新的远程指导应用,即在使用双极能量进行经尿道前列腺剜除术(TUEB)的学习曲线期间。
我们的工程部开发了一种远程指导系统。该应用程序用于指导由一位经验丰富的腔内泌尿科医生(TUEB 的新手)进行的十例 TUEB 前瞻性病例。手术医生和导师填写了一份问卷,对远程指导系统进行主观评估。最后,将这些患者的结果与由导师进行的十例连续患者的对照组进行比较。
使用这种远程指导应用程序进行了十例连续的 TUEB。两名患者分别经历了延迟和中断连接,但它们的影响很小,并不影响手术的安全性。我们的系列中没有患者需要转换为传统的经尿道前列腺切除术。仅在我们的系列中,有一位患者出现 IIIb 级并发症。
TUEB 的远程指导应用具有前景。它是一种简单且低成本的工具,可以在没有时间和地点限制的情况下,为导师和学员提供安全保障,是确保学习曲线初始阶段患者安全的可行选择;然而,应该指出的是,远程指导还不能替代传统的与导师和学员在手术室中的手术培训。需要进一步的研究来证实当前的结果。