Background/Purpose: Telemedicine affords the opportunity to extend the
presence of surgical evaluation to centers without an on-site pediatr
ic surgeon. However, concern for cost, accuracy of diagnosis, and phys
ician acceptance have limited its use. Methods: Using a low-cost, desk
top computer-based system, this study was designed to test the effecti
veness of telemedicine in neonatal surgical consultation. Results: Ear
ly experience with six video-teleconference (VTC) and six store-and-fo
rward consultations are presented. Diagnosis was established accuratel
y in all cases. With the three intestinal cases (jejunal atresia, dupl
ication cyst, and r/o malrotation), diagnostic studies were guided by
the images transmitted with the consult. Earlier care could be impleme
nted in other cases. Technical problems were encountered primarily wit
h the VTC modality, which also proved more consuming of physician time
. Conclusions: Telemedicine was used successfully in each case and pro
ved accurate in diagnosis and guiding further evaluation. This is the
first report of the use of telemedicine for surgical consultation in t
he intensive care nursery.