Live Surgical Demonstrations: An Old, but Increasingly Controversial Practice

Duty, Brian; Okhunov, Zhamshid; Friedlander, Justin I.; Okeke, Zeph; Smith, Arthur D.

doi:10.1016/j.urology.2011.12.037

Cited by 41 publications

(33 citation statements)

References 8 publications

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“…Recently, there is increasing concern that a conventional live demonstration may actually be risky to patients because the invited external faculty may be tired from long overseas trips and have to perform demonstrations in an unfamiliar environment, which inevitably increases their anxiety level. Furthermore, the experts frequently are distracted by questions 10. Hence, broadcasting live demonstrations from a faculty member’s own facility eliminates, in part, the unfavorable element of working in an unfamiliar environment and negates the need to acquire temporary medical licenses and special malpractice coverage.…”

Section: Discussionmentioning

confidence: 99%

Telemedicine for gastrointestinal endoscopy: The Endoscopic Club E-conference in the Asia Pacific Region

Rerknimitr

Kudo

et al. 2017

Endosc Int Open

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Background and study aims An Endoscopic Club E-conference (ECE) was set up in May 2014 to cater to increased demand for gastrointestinal endoscopy-related teleconferences in the Asia-Pacific region which were traditionally organized by the medical working group (MWG) of Asia-Pacific Advanced Network. This study describes how the ECE meeting was run, examines the group dynamics, outlines feedback and analyzes factors affecting the enthusiasm of participants. It is hoped that the findings here can serve as guidance for future development of other teleconference groups. Methods The preparation, running of and feedback on the ECE teleconference were evaluated and described. The country’s economic situation, time zone differences, connectivity with a research and education network (REN) and engineering cooperation of each member were recorded and analyzed with regard to their association with participant enthusiasm, which was taken as participation in at least 50 % of the meetings since joining. Associations were calculated using 2-way table with chi-square test to generate odds ratio and P value. Results To date, ECE members have increased from 7 to 29 (increment of 314 %). Feedback received indicated a high level of satisfaction with program content, audiovisual transmission and ease of technical preparation. Upper gastrointestinal luminal endoscopy-related topics were the most favored program content. Those topics were presented mainly via case studies with a focus on management challenges. Time zone differences of more than 6 hours and poor engineering cooperation were independently associated with inactive participation (P values of 0.04 and 0.001 respectively). Conclusions Good program content and high-quality audiovisual transmission are keys to the success of an endoscopic medical teleconference. In our analysis, poor engineering cooperation and discordant time zones contributed to inactive participation while connectivity with REN and a country’s economic situation were not significantly associated with participant enthusiasm.

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Section: Discussionmentioning

confidence: 99%

Telemedicine for gastrointestinal endoscopy: The Endoscopic Club E-conference in the Asia Pacific Region

Rerknimitr

Kudo

et al. 2017

Endosc Int Open

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“…2 In addition to the traditional teaching of minimally invasive surgery skills in the operating room, communication via conferences and workshops is increasingly used as a teaching method in laparoscopic surgery education. 2,4,5 Our hospital initiated laparoscopic surgeries since the early 1990s. As one of the leading institutions in laparoscopic surgery in China, our Department started to host national CME workshops for laparoscopic surgery beginning in 2004.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 However, skilled clinicians face fatigue when traveling for real-time demonstrations at away institution. 5,6 On the other hand, live demonstration via the Internet makes it feasible for specialists from different countries to conduct real-time demonstrations remotely, 3,[7][8][9] thus eliminating the time and expense of travel. Because of bandwidth limitation, the traditional videoconference system based on the code/decode technique has disadvantages of dropped video frames or distortion of images.…”

mentioning

confidence: 99%

Application of International Videoconferences for Continuing Medical Education Programs Related to Laparoscopic Surgery

Huang

Cen²,

Qiu³

et al. 2014

Telemedicine and e-Health

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Background: Continuing medical education (CME) is an effective way for practicing physicians to acquire up-to-date clinical information. Materials and Methods: We conducted four CME seminars in 2007-2010 endorsed by the Chinese Medical Association Council on Medical Education. Overseas telelectures and live case demonstrations were introduced in each seminar via telemedicine based on a digital video transport system. Network stability and packet loss were recorded. An anonymous mini-questionnaire was conducted to evaluate the satisfaction of attendees regarding the image and sound quality, content selection, and overall evaluation. Results: Four telelectures and five live case demonstrations were successfully conducted. Stability of the network was maintained during each videoconference. High-quality videos of 720 · 480 pixels at the rate of 30 frames per second were shown to the entire group of attendees. The time delay between Shanghai and Fukuoka, Japan, was only 0.3 s, and the packet loss was 0%. We obtained 129 valid responses to the mini-questionnaire from a total of 146 attendees. The majority of the attendees were satisfied with the quality of transmitted images and voices and with the selected contents. The overall evaluation was ranked as excellent or good. Conclusions: Videoconferences are excellent channels for CME programs associated with laparoscopic training.

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“…Om de patiëntveiligheid te waarborgen, hebben meerdere chirurgische verenigingen richtlijnen opgesteld voor de uitvoering en organisatie van live chirurgie [3]. De European Association of Urology (EAU) introduceerde in 2014 een richtlijn met daarin ondersteunende informatie voor het organiseren en veilig uitvoeren van live chirurgie.…”

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“…Buiten deze richtlijn is de literatuur met betrekking tot de veiligheid van live chirurgie binnen de urologie schaars. De meerderheid van de uitgevoerde studies zijn beleidspublicaties of enquêtes [1,[3][4][5][6]. De conclusies van deze studies zijn vaak gebaseerd op opinies en niet op empirisch onderzoek naar behandeluitkomsten.…”

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Resultaten van vijf jaar live chirurgie voor endo-urologische behandeling van urinewegstenen

et al. 2018

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SamenvattingDeze retrospectieve studie vergelijkt de behandeluitkomsten voor urinewegstenen van live endo-urologische procedures (live EP) met die van routine endo-urologische procedures (routine EP). Over een periode van vijf jaar werden er 666 ureteroscopische (URS) en 182 percutane (PNL) niersteenbehandelingen verricht, waarvan 151 live EP's. Intraoperatieve complicaties tijdens URS traden op bij 3,2% van de live EP's en 2,5% van de routine EP's (p = 0,72) en postoperative complicaties bij 13,7% van de live EP's en 8,8% van de routine EP's (p = 0,13). Intraoperatieve complicaties tijdens PNL traden op bij 8,9% van de live EP's en bij 5,6% van de routine EP's (p = 0,52) en postoperatieve complicaties bij 28,6% van de live EP's en bij 34,9% van de routine EP's (p = 0,40). Binnen de URS-en de PNL-groepen was er geen significant verschil in Clavien-Dindo-complicatiegraden. Multipele regressieanalyse toonde geen associatie tussen live EP en minder gunstige behandeluitkomsten. Live EP's, zoals uitgevoerd in deze setting, lijken behandeluitkomsten niet te benadelen wanneer deze worden vergeleken met routine EP's.Trefwoorden stenen -urolithiasis · live chirurgie · ureterorenoscopie · percutane nefrolithotomie Outcome from five-year live endourological urinary stone treatment Are outcomes compromised?Abstract This retrospective study compares treatment outcomes for urinary stones of live surgical procedures (LSP) and routine surgical procedures (RSP). Over a five-year period, 666 ureteroscopic (URS) and 182 percutaneous (PNL) procedures were performed, of which 151 LSP's. Among the URS-groups, the intra-and postoperative complication rates were 3.2% for LSP and 2.5% for RSP (p = 0.72), respectively 13.7% for LSP and 8.8% for RSP (p = 0.13). Among the PNL-groups, the intra-and postoperative complication rate were 8.9% for LSP and 5.6% for RSP (p = 0.52), respectively 28.6% for LSP and 34.9% for RSP (p = 0.40). There were no statistically significant differences in Clavien-Dindo complication grades within the URS-and PNL-groups. Multiple regression analyses revealed no association between LSP and less favorable outcomes as compared to RSP. Live surgical endourological demonstrations, as performed in this setting, do not seem to compromise outcomes. IntroductieLive chirurgie is een populair educatiemiddel. Met het toenemen van de populariteit van live chirurgie worden de educatieve waarde, professionele en financiële belangen-

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Live Surgical Demonstrations: An Old, but Increasingly Controversial Practice

Cited by 41 publications

References 8 publications

Telemedicine for gastrointestinal endoscopy: The Endoscopic Club E-conference in the Asia Pacific Region

Telemedicine for gastrointestinal endoscopy: The Endoscopic Club E-conference in the Asia Pacific Region

Application of International Videoconferences for Continuing Medical Education Programs Related to Laparoscopic Surgery

Resultaten van vijf jaar live chirurgie voor endo-urologische behandeling van urinewegstenen

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