Remote Telementoring for Laparoscopic Sleeve Gastrectomy During COVID-19

Overview

This study reports the first worldwide experience of telementoring for laparoscopic sleeve gastrectomy (LSG) during the COVID-19 pandemic. Eight consecutive LSG cases were successfully performed with remote coaching, showing a significant reduction in operative time as experience increased and no intraoperative complications.

Background

Laparoscopic sleeve gastrectomy is the most common bariatric procedure, requiring a significant learning curve to minimize complications. Traditionally, surgical mentoring occurs onsite with the expert physically present. The COVID-19 pandemic interrupted non-urgent surgeries and limited travel, necessitating alternative training methods. Telementoring, a telemedicine technique for remote surgical guidance, emerged as a vital tool to continue surgical education and proctoring during these restrictions.

Data Highlights

Key Findings

• Eight LSG procedures were completed successfully using a telementoring platform without intraoperative complications or conversions.
• Patients had a mean age of 36.9 years and mean BMI of 41.8 kg/m2.
• Mean operative time was 112.4 minutes with a significant decrease from the first four to the last four cases (130.3 vs 94.5 minutes; P = 0.005).
• Strong correlation observed between case number and operative time (r² = 0.9; P < 0.01), indicating improved efficiency with experience.
• The telementoring platform allowed real-time audio-video interaction and text communication despite low-speed internet and no augmented reality features.
• Remote coaching enabled continuation of surgical training during COVID-19 travel restrictions and reduced elective surgeries.

Clinical Implications

Telementoring can effectively support surgical training in bariatric procedures like LSG when onsite mentoring is not feasible, ensuring patient safety and operative efficiency. This approach may expand access to expert guidance, particularly during pandemics or in resource-limited settings, and could be integrated into future surgical education programs.

Conclusion

Remote telementoring is a feasible and effective method for guiding surgeons through the laparoscopic sleeve gastrectomy learning curve, maintaining surgical quality and safety during challenging circumstances such as the COVID-19 pandemic.

References

1. S.I.C.OB. Guidelines 2020 -- Bariatric Surgery During COVID-19
2. Recent Teleproctoring Study 2021 -- Teleproctoring for Endoscopic Sleeve Gastroplasty
3. Surgical Learning Curve Literature -- LSG Training Requirements