Telementoring in Endocrine Surgery: Preliminary Indian Experience

Abstract

Telemedicine is starting to play an important role in the health field in India. In this case report we describe the successful use of telementoring to remove a parathyroid tumor in a patient with residual hyperparathyroidism after two previous unsuccessful attempts in tumor excision. A 21-yr-old patient crippled with advanced hyperparathyroidism was taken up for third-time exploration at Amrita Institute of Medical Sciences (AIMS), Kochi, with guidance from the Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, using telemedicine technology. These two centers are located 2,500 km apart, and telementoring from the more experienced endocrine surgeons at SGPGIMS resulted in successful tumor localization and removal. For this session both the institutions were provided with a dedicated 512 Kbps very small aperture terminal (VSAT) link and two-way video-audio connectivity. Even though two previous explorations were unsuccessful, with the help of telemedicine technology the same surgeon was successful in locating and removing the tumor. The video and audio quality was of good enough quality for the expert at SGPGIMS to guide the team at AIMS satisfactorily. The patient benefited since he did not have to travel to a far-off specialized center for surgery. This case report testifies to the usefulness of telemedicine in the field of surgery, especially in developing countries, which have few medical experts in certain specialized areas.

Telemedicine—An efficient and cost‐effective approach in parathyroid surgery

“…The nature of parathyroid surgery lends itself to a wide referral base,22 particularly from endocrinologists referring to a center that performs a high volume of these surgeries 23, 24. Telemedicine can become a powerful tool for managed healthcare organizations responsible for the medical needs of widely distributed patients in a vertically integrated healthcare delivery system 3.…”

A Framework for Studying Perceptions of Rural Healthcare Staff and Basic ICT Support for e-Health Use: An Indian Experience

“…However, there are some scattered attempts by the Indian researchers to showcase the clinical benefits of telemedicine practice. 21,22 Recognizing this gap in the current e-health research in Indian perspective, this article attempts to study the awareness of e-health among a set of healthcare staff and preparedness at the organizational level based on the available ICT support at a group of rural PHCs in eastern India. To do so, the article discusses a complete framework that consists of the following:…”

What Is “Telemedicine” and What Does It Mean for a Pediatric Surgeon?

“…14 Teleproctoring: An expert observes another without giving advice or interfering to evaluate the latter's performance. 16 Telementor: This is an expert who instructs another individual (usually not as skilled as the telementor in that particular field) from a remote location via a live sound and video feed.…”

“…For example, videoconferencing equipment, digital cameras, optical equipment, microphone, and broadband connectivity. 16 The above devices enable the interactive and real-time instructing of techniques to a student. Also, the teleproctor should be able to see, assess, and/or evaluate the performance of the trainee.…”

“…An expert observes another without giving any advice or by interfering to evaluate the latter's performance. 16 It can be applied in pediatric surgery as a way to assess whether the skills have been acquired by the trainee surgeon. This requires a measurement matrix to evaluate the outcome (skill acquisition and knowledge).…”