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Sleeve Gastrectomy Telementoring: A SAGES Multiinstitutional Quality Improvement Initiative

Ninh T Nguyen1, Allen Okrainec2, Mehran Anvari3, Oz Meireles4, Denise Gee4, Keith Scharf5, Brian Smith1, Erin Moran-Akin6, Diego Camacho6. 1UCI, 2Toronto Western Hospital, 3McMaster University, 4Massachusetts General, 5Loma Linda University, 6Montefiore Medical Center

INTRODUCTION: Sleeve gastrectomy represents a procedure that developed as a result of a rapid and constant innovation in the field of bariatric surgery. With any newly developed operations or procedures, there is often an associated learning curve that can be associated with higher morbidity and possibly higher mortality. Real-time surgical mentoring reduces the learning curve of a new procedure but can be costly and time consuming for the mentor. The aim of this initiative was to evaluate the feasibility for remote mentoring of laparoscopic sleeve gastrectomy through a formal learning process and real-time surgical guidance.

METHODS: We reviewed the experience of 14 mentee who underwent sleeve gastrectomy with real-time surgical guidance by 7 mentors. The surgical mentoring was performed using the Visitor 1 remote presence system with two-way live audio and video communication. The receiving platform utilizes a conventional laptop, Ipad, or Iphone. After completion of the didactics on sleeve gastrectomy, the mentee proceed to teleobservation and followed by telementoring of 2-3 cases. The overall telementoring experience was scored between 1 for poor and 5 for excellent.

RESULTS: From the mentee viewpoint, 91% reported the quality of telecommunication exceeded expectation; 82% for latency; 91% for visual clarity, and 73% for sound clarity. The overall telementoring experience was scored at 4.8. From the mentor viewpoint, 50% reported that quality of telecommunication exceeded expectation; 50% for latency; 40% for visual clarity, and 40% for sound clarity. The overall telementoring experience was scored at 4.7. 100% of mentors stated that they were satisfy with their ability to mentor the mentee and there were no unexpected intraoperative occurrences. There were several logistic limitations including effective schedule of cases, delay of cases, poor communication of mentor and mentee on the day of mentoring, failure of mentee to attend case observation or failure of mentor to setup the telementoring equipment. Other limitations include the inability to control the mentee acceptance of guidance.

CONCLUSIONS: Surgical telementoring is feasible and was highly rated by the mentee and well rated by the mentor. Telementoring platform provides a convenient educational tool that likely would reduces the morbidity associated with the learning curve of newly developed surgical procedures.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 80817

Program Number: S114

Presentation Session: Education Technology, Teaching and Learning

Presentation Type: Podium

34

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