Background: Telemedicine offers significant advantages in bringing con
sulting support to distant colleagues. There is a shortage of surgeons
trained in performing advanced laparoscopic operations. Aim: Our aim
was to evaluate the role of telementoring in the training of advanced
laparoscopic surgical procedures. Methods: Student surgeons received a
uniform training format to enhance their laparoscopic skills and intr
acorporeal suturing techniques and specific procedural training in lap
aroscopic colonic resections and Nissen fundoplication. Subsequently,
operating rooms were equipped with three cameras. Telestrator (telegui
dance device), instant replay (to critique errors), and CD-ROM program
s (to provide information of reference) were used as intraoperative ed
ucational assistance tools, In phase I, four colonic resections were p
erformed with the mentor in the operating room (group A) and four colo
nic resections were performed with the mentor on the hospital grounds,
but not in the operating room (group B). The voice and video signals
were received at the mentor's location, using coaxial cable. In phase
II, two Nissen fundoplications were performed with the mentors in the
operating room (group C) and two Nissen fundoplications were performed
with the mentors positioned five miles away from the operating room (
group D), using currently existing land lines at the T-1 level. Result
s: There were no differences in the performances of the surgeons and o
utcome of the operations between groups A & B and C & D, It was possib
le to tackle the intraoperative problems effectively. Conclusions: The
telementoring concept is potentially a safe and cost-effective option
for advanced training in laparoscopic operations. Further investigati
on is necessary before routine transcontinental patient applications a
re attempted.