Fig. 10.1
The Network Configuration. Online broadcasting of a videoscopic courses with “webtelesurgery.com”
Low-bandwidth internet-based telemedicine is effective and inexpensive. Surgeons living in remote areas, distant countries and especially those with limited resources, can follow the videoscopic courses, meetings and live surgeries organized by experienced centres, on their computer screen, in real-time and interactively.
Convention with ESLS in Brussels and Cooperation with MMESA
The European School of Laparoscopic Surgery (ESLS) at the Saint-Pierre University Hospital in Brussels is one of the oldest and famous schools of laparoscopic surgery in Europe. ESLS in Brussels and ISTEM & ELCD in Istanbul have created a convention on tele-training and tele-teaching using the Webtelesurgery platform. With this convention, we have established a partnership with MMESA (Mediterranean and Middle-eastern Endoscopic Surgery Association) to broadcast courses, congresses or specific educational training sessions about MAS, organized by ourselves and/or by famous teams in Europe and the Middle East. MMESA includes 36 Countries around the Mediterranean Sea and the Middle East. It is an open association and other countries from Africa, the Black Sea region or Central Asia have also joined this project.
The ESLS regularly organizes 15–17 advanced laparoscopic courses (general, bariatric, colorectal, hernia repair, trans-oral foregut and nursing) every year in St. Pierre University Hospital in Brussels. The group of ISTEM-ELCD also organize courses and educational meetings in Istanbul. For 5 years, we have transmitted some of these courses and activities, via the webtelesurgery platform to the world, especially to the MMESA countries. These transmissions are always free of charge and many surgeons, especially from the developing countries can be connected very easily and at a very low cost, needing only a computer and simple internet connection. Earlier technical difficulties with the sound and the quality of the picture have been overcome.
Live Broadcasting of Meetings and Congresses
In recent years, thanks to our portable teleconferencing system, we conducted live broadcasts of a f meetings and conferences from France, to the French-speaking countries of North Africa. Meeting “Mesh” in 1998, 99 and 2001, organized in Paris by the French Laparoscopic Surgery Society (SFCL) team were sent via Internet using our teleconferencing system, to Maghreb countries. Many surgeons in Algeria, Tunisia and Morocco are connected and supported by distance interactively (question-response by phone/Skype) in this meeting
In 2008 and 2009, the Video Forum in Digestive Surgery, organized by the University of Toulouse in France, was transmitted to francophone countries. The two Congresses of Coelio Surgery Lyon, which took place in Lyon, France, in 2011.
Broadcasting of Videoscopic Surgery Courses Between Turkey and Azerbaijan
Live bariatric surgery courses were organized by the ELCD team in İstanbul University Hospital and broadcast through the internet to the Medical University of Azerbaijan, Baku in 2014 (Fig. 10.2). Twenty two Turkish surgeons on site in the meeting room of ISTEM in Istanbul and more than a hundred Azeri surgeons participated online in Baku. The audio-visual connection between the operating room and the conference room of ISTEM in Istanbul was made by the hospital’s intranet (LAN). Re-transmission of the course content (live operations and discussions) was carried out via the internet in real time using our teleconference system of “webtelesugery.com”. The return of video and audio from Baku to Istanbul was through Skype. The quality of picture and sound was satisfactory in spite of the relatively long time delay. This experience of telemedicine between Istanbul and Baku was encouraging for us to continue collaboration through telemedicine with the Azerbaijan and subsequently with other Turkish-speaking countries.
Fig. 10.2
Broadcasting of videoscopic surgery courses between Turkey and Azerbaijan
Our Experience of Local and Remote Telementoring in MAS
We use the telementoring in different ways, depending on the near (Local telementoring in the residency programme) or distant location (Remote telementoring in the national programme). The installation, preparation and tele-connection are slightly different.
Local Telementoring/Telestration in Residency Programme
We regularly use the local telementoring in our hospital to train our residents and young surgeons. Of course, direct (on site) mentoring in operating room for less experienced surgeons is better, but in current practice, it is still not possible, due the very busy schedule and other obligations of a university professor. For this reason, telementoring in university and non-academic educational hospitals is efficacious and recommended, as a complementary method for residency training in surgery. When we are not available to assist the less experienced resident in operating room, we can connect online from our office, see the outcome of surgery and if necessary can help him/her with telementoring or telestration. Teleconnection is made relatively easily and effectively with the hospital intranet (LAN). This easy and low cost telementoring prototype is based on a standard personal computer with a media player (Aver Media Player card), a free software encoder programme (Adobe Flash Media Live Encoder 3) and a tablet (Fig. 10.3).
Fig. 10.3
The schema of the telementoring/telestration in our hospital to train our residents
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