Feasibility of a telementoring approach as a practical training for transurethral enucleation of the benign prostatic hyperplasia using bipolar energy: a pilot study.

Marco Amato,Giampaolo Bianchi,Bernardo Rocco,Isotta Landi,Giulio Guarino,Federica Ferraguti,Cristian Secchi,Maria Chiara Sighinolfi,Stefano Puliatti,Marco Minelli,Salvatore Micali,Agostino Meneghini,Ahmed Eissa

doi:10.1007/s00345-021-03594-9

Abstract

IntroductionTelementoring 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).Material and methodsA 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.ResultsTen 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.ConclusionThe 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 resultsSupplementary InformationThe online version contains supplementary material available at 10.1007/s00345-021-03594-9.

Highlights

Telementoring is one of the applications of telemedicine capable of bringing highly experienced surgeons to areas lacking expertise
20 patients were included in the current study, of which, ten consecutive patients in the surgeon’s institute were prospectively enrolled in the telementoring group, and the data of ten consecutive patients were retrospectively collected from the mentor’s institute to form the control group
In the telementoring group, all patients were continent at the time of catheter removal except for one patient (10%) who suffered from incontinence that was managed with pharmacological therapy (Clavien–Dindo II)

Summary

Introduction

Telementoring is one of the applications of telemedicine capable of bringing highly experienced surgeons to areas lacking expertise. Conclusion 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; it should be mentioned that telementoring cannot yet replace the traditional surgical training with the mentor and trainee being in the operative room. Apprenticeship is the origin of Halstedian model of training “see one–do one–teach one”, which, is an effective training model but it has been associated with a prolonged training period in order to attain the required surgical skills [4] In these settings, the reduction of the available training hours (for both trainees and trainers), the increased cost of training, the rapid technological advancements in the field of telecommunication and surgical instrumentation, and the steep learning curve of certain surgical procedures resulted in. The first telementoring experience dates back to 1997, when, Rosser et al [10], reported the feasibility of telementoring for advanced training of laparoscopic colectomy

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Conclusion