A Model for Longitudinal Mentoring and Telementoring of Laparoscopic Colon Surgery

OBJECTIVE: To demonstrate the feasibility of longitudinal mentoring and telementoring of community surgeons in laparoscopic colon surgery.
METHODS: A formal mentoring protocol was established between a university centre and surgeons at a local 134 bed community hospital 60km away. The community surgeons (CS) attended a didactic course on laparoscopic colon surgery before attending surgery at the mentoring institution. Equipment at the community hospital was evaluated and upgrades recommend. Patients were identified from the CS practice and referred for approval through formal consultation with the mentor. The mentor worked with the same two CS on every case in their local hospital. Procedure outcomes were recorded using CAESaR (Canadian Advanced Endoscopic Surgery Registry) practice audit software. The mentoring endpoint was 20 cases based on ASCRS / SAGES guidelines.
RESULTS: From March 2006 to August 2007, 40 patients underwent elective colon surgery by the CS, 20 of whom were referred and accepted for laparoscopic mentoring. The remaining 20 had open surgery. After the first nine cases the MS did not scrub and provided verbal guidance only. Beginning with case 15, procedures were telementored with the exception of a subtotal colectomy for which the MS assisted. Patients selected for laparoscopic mentoring (7F, 13M) as compared to open unmentored cases (8F, 12M) were younger (60±13yrs vs. 72±17yrs, p=0.013), less likely to have cancer (50% vs. 70%, p=0.33) and tended to require less complex resections (11 right, 7 sigmoid, 1 subtotal colectomy, 1 anterior resection vs. 5 right, 5 sigmoid, 4 subtotal, 2 transverse, 1 left colectomy, 3 anterior resections). There were no conversions. Mentored cases took longer operating time (150±43min vs. 108±40min, p=0.003) but resulted in shorter hospital stay (median 2.5 vs. 7.0 days, p

Session: Podium Presentation

Program Number: S028

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