Long distance telementoring - A novel tool for laparoscopy aboard the USS Abraham Lincoln

Background: As general surgeons perform a growing number of laparoscopic op erations in increasingly specialized environments, the ability to obtain ex pert advice during procedures becomes more important. Technological advance s in Video and computer communications are enabling surgeons to procure exp ertise quickly and efficiently. In this article, we present laparoscopic pr ocedures completed through an intercontinental telementoring system and the first telementored laparoscopic procedures performed aboard a naval vessel . Methods: Video, voice, and data streams were linked between the USS Abraham Lincoln Aircraft Carrier Battlegroup cruising the Pacific Ocean and locati ons in Maryland and California, creating the Battlegroup Telemedicine (BGTM ) system. Three modes of BGTM communication were used: intraship, ship to s hip, and ship to shore. Results: Five laparoscopic inguinal hernia repairs were completed aboard th e Lincoln under telementoring guidance from land-based surgeons thousands o f miles away. In addition, the BGTM system proved invaluable in obtaining t imely expertise on a wide variety of surgical and medical problems that wou ld otherwise have required a shore visit. Conclusions: Successful intercontinental laparoscopic telementoring aboard a naval vessel was accomplished using "off-the-shelf" components. In many i nstances, the high risk and cost of transporting patients to land-based fac ilities was averted because of the BGTM system. Also, the relationship betw een the on-site and telementoring surgeon was critical to the success of th is experiment. Long-distance telementoring is an invaluable tool in providi ng instantly available expertise during laparoscopic procedures.