Laparoscopic Liver Resection by Distance Mentoring – Trinidad to Barbados: A Report

Abstract

Laparoscopic liver resections require advanced laparoscopic skill sets. In the Caribbean, a unique situation exists where centers of excellence for liver resections exist, but surgeons who are trained in advanced laparoscopic surgery are not available throughout the region. Therefore, many patients who are candidates for liver resection in the Caribbean do not have the opportunity to receive laparoscopic operations. We report a case of distance mentoring using readily available, inexpensive equipment to complete a laparoscopic liver resection, mentored by an expert hepatobiliary surgeon. It may be considered, in special cases, as a way to increase the availability of laparoscopic operations. We acknowledge that there are many limitations to the use of this technology and we discuss the pros and cons of distance mentoring for this purpose.

Laparoscopic Hepatectomy via Remote Mentoring From Jamaica to Trinidad

“…We propose that distance mentoring may be a solution when there are competent surgeons who possess the necessary advanced skill sets to complete laparoscopic hepatectomies. Mentoring is the well-accepted concept where an experienced surgeon coaches a less experienced colleague [4][5][6]. We extended the traditional mentoring concept to one where the mentor only present virtually [4].…”

“…Mentoring is the well-accepted concept where an experienced surgeon coaches a less experienced colleague [4][5][6]. We extended the traditional mentoring concept to one where the mentor only present virtually [4].…”

“…In Jamaica, the primary surgeon stood between the patient's legs, comfortably able to visualize the working monitors (Figure 3 ). A previously described technique utilizing Apple iPhones® [ 4 ] was used to stream live feed of the laparoscopic video and the operating field to the remote mentor.…”

“…The remote mentor virtually observed the operating field and gave instructions to choose resection margins and transect hepatic parenchyma using ultrasonic dissectors [ 4 ] (Figure 4 ).…”

Developing Laparoscopic Surgery on the Caribbean Island of St. Lucia: A Model for Public-Private Partnership

“…The local surgeons have all become active members of these associations and attend all regular training events. In addition, the concept of distance mentoring was developed in the Caribbean to serve as a continued educational and mentoring tool for new laparoscopic startup units [20] and this was one form of continued education at Victoria Hospital.…”