Robotic pyeloplasty using internet protocol and satellite network‐based telesurgery

Nguan, Christopher; Morady, R.; Wang, C.; Harrison, David J.; Browning, D. G.; Rayman, Reiza; Luke, Patrick

doi:10.1002/rcs.173

Cited by 35 publications

(21 citation statements)

References 12 publications

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“…9,10 Studies in the adult population have so far been mainly limited to the application of remote telesurgery, with the advent of robotic surgical systems. 11,12 Some small, single-centre studies of the adult urological population and telemedicine in the U.S. have so far shown good patient/provider satisfaction and success. [13][14][15][16] There are no reports of using provider-to-provider eConsults in urology.…”

Section: Introductionmentioning

confidence: 99%

Improving access to urologists through an electronic consultation service

Witherspoon

Liddy²,

Afkham³

et al. 2017

CUAJ

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Introduction: Access to specialist services is limited by wait times and geographic availability. Champlain Building Access to Specialist Advice (BASE) has been implemented in our service region to facilitate access to specialists by primary care providers (PCPs). Through a secure web-based system, PCPs are able to send eConsults instead of requesting a formal in-office consultation. Methods: Urology eConsults completed through the Champlain BASE service from March 2013 to January 2015 were analyzed. Each consult was characterized in regard to the type of question asked by the referring physician and the clinical content of the referral. Using the mandatory close-out surveys, we analyzed rates of referral avoidance, physician satisfaction, and overall impact on patient care. Results: Of 190 eConsultations, 70% were completed in less than 10 minutes. The most common clinical questions related to the interpretation of imaging reports (16%) and tests to choose for investigating a condition (15%). The most common diagnoses were hematuria (13%) and renal mass (8%). In 35% of cases, referral to a urologist had originally been contemplated and was avoided. In 8% of cases, a PCP did not believe a consultation was initially needed, but a referral was ultimately initiated after the eConsultation. Conclusions: Our study shows that although certain clinical presentations still require a formal in-person urological consultation, eConsultations can potentially reduce unnecessary clinic visits while identifying patients who may benefit from early urological consultation. Through both these mechanisms, we may improve timely access to urologists.

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Section: Introductionmentioning

confidence: 99%

Improving access to urologists through an electronic consultation service

Witherspoon

Liddy²,

Afkham³

et al. 2017

CUAJ

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“…Operative duration with real-time connection (41.3 +/-15.0 min) was not significantly different vs. VPNe landline (47.0+/-24.1 min) vs. satellite (51.8+/-4.7 min). The anastomotic competence of the pyeloplasty procedures were excellent in all groups as well [14]. Although it was subjectively more challenging to perform pyeloplasty in the landline and satellite groups, it was shown that complex operative procedures requiring delicate suturing and knot tying could be accomplished using long-distance landline and satellite connections.…”

Section: Wwwintechopencommentioning

confidence: 92%

“…The satellite network was privately partitioned with 10 Mbps bandwith. The routing was a round trip connection from London to Toronto, Ontario, to a telecommunications satellite (Telesat Canada) operating in the Ku band (12-14 GHz) and back to London Ontario, traversing a distance of 71,000 km [14]. Fig.…”

Section: Limitations Of Telesurgerymentioning

confidence: 99%

Telementoring and Telesurgery: Future or Fiction?

Silva¹,

McGregor²,

Rayman³

et al. 2010

Robot Surgery

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“…Our group has recently described the use of an internet protocol virtual private network and satellite links to ascertain the feasibility of long-distance surgery using both the Zeus and da Vinci robotic platforms. 92,93 Results of porcine RALPs indicated that proficient complex reconstructions can be achieved despite significant network latency and occasional jitter. As the technology evolves, the clinical implications of remote telesurgery will become tangible.…”

Section: The Futurementioning

confidence: 99%

Robotic renal surgery: The future or a passing curiosity?

Warren

Silva

Caumartin

et al. 2013

CUAJ

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The development, advancement and clinical integration of robotic technology in surgery continue at a staggering pace. In no other discipline has this rapid evolution occurred to a greater degree than in urology. Although radical prostatectomy has grown to become the prototypical application for the robot, the role of the robot in renal surgery remains controversial. Herein we review the literature on robotic renal surgery. A comprehensive PubMed literature search was performed to identify all published reports relating to robotic renal surgery. All clinically related articles involving human participants were critically appraised in this review. Fifty-one clinical articles were included, encompassing robot-assisted pyeloplasty, nephrectomy, nephroureterectomy, living-donor nephrectomy and partial nephrectomy. Feasibility has been shown for each of these procedures. Robot-assisted techniques have been described for almost all renal-related procedures. However, the intersect between feasibility and necessity as it pertains to robotic renal surgery has yet to be defined. Also, the high cost of surgical robotic technology mandates critical appraisal before adoption, especially in a publicly funded health care system, such as the one present in Canada. RésuméLe développement, le perfectionnement et l'intégration en milieu clinique de la technologie robotique en contexte opératoire se poursuit à un rythme stupéfiant. Aucune autre discipline n'a vu cette évolution rapide à un niveau aussi élevé que l'urologie. Alors que la prostatectomie radicale en est devenue l'application prototype, le rôle de la robotique en chirurgie rénale demeure controversé. Dans l'article qui suit, nous passons en revue la littérature portant sur l'emploi de la robotique en chirurgie rénale. Une recherche exhaustive dans la base de données PubMed a été effectuée afin de cerner les rapports sur le sujet. Tous les rapports cliniques portant sur des sujets humains ont été évalués. Cinquante et un articles cliniques ont été inclus dans notre analyse, incluant des cas, tous assistés par robot, de pyéloplas-tie, de néphrectomie, de néphro-urétérectomie, de néphrectomie chez des donneurs vivants et de néphrectomie partielle. Pour chacune de ces interventions, la faisabilité a été démontrée. Des techniques assistées par robot ont été décrites pour pratiquement tous

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Robotic pyeloplasty using internet protocol and satellite network‐based telesurgery

Abstract: The completion of complex tasks such as robotic pyeloplasty is feasible using both land-line and satellite telesurgery. However, the clinical relevance of telesurgery requires further assessment.

Cited by 35 publications

References 12 publications

Improving access to urologists through an electronic consultation service

Improving access to urologists through an electronic consultation service

Telementoring and Telesurgery: Future or Fiction?

Robotic renal surgery: The future or a passing curiosity?

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