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Should that be Telesurgery or Telementoring?
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<h4>Dr. McKinley conducts surgery at <br>North Bay General Hospital</h4>

Dr. McKinley conducts surgery at
North Bay General Hospital

Should that be Telesurgery or Telementoring?

Canada's first ever tele-robotic assisted surgery demonstration between Hamilton and North Bay has important implications for your community hospital.

About a year ago many major Canadian newspapers carried a story about Canada's first demonstration of telesurgery.

Many of the articles painted a picture of a heroic effort made by surgeon and technologists working together to save lives at a distance. Visions of urban physicians performing surgery on desperate patients located in Antarctica and on the Space Station come to mind. But what does this story have to do with you, and the quality of medical care that you might hope to receive at your hospital, during your life time?

The answer is, "Lots!!"

We think that the headlines should have read:
"Talented young Dr. Craig McKinley in North Bay Community Hospital Assisted in Surgery by a Leading Surgical Specialist Dr. Anvari located 200 miles away."

Dr. McKinley is one of a diminishing breed of ambitious young surgeons who has decided to make his life and his career in a community located far from the resources of a teaching hospital. The rewards of living and working in a smaller community are many, but for an ambitious young surgeon who wants to continue to grow professionally, working without the support of expert mentors like Dr. Anvari could represent a career dead end.

Dr. McKinley's ambition is to become a leader in the area of Advanced Laproscopic Surgery.

Telesurgery could bring your community the best that surgical medicine has to offer.Traditional surgery requires that a large incision be made in the patient so that the surgeon can access the organs in question with their hands. Laproscopic surgery involves instead, the insertion into the patient of small ports through which a camera and specialized equipment is inserted. Working with these specialized instruments, the surgeon can perform many abdominal procedures without the need for large incisions.

Benefit to the patient; no large incisions and recovery from major surgery in days rather than weeks.

Benefit to the health care system;
<h4>Dr. Anvari controls robotic end effectors <br>from Hamilton St. Joseph's Healthcare</h4>

Dr. Anvari controls robotic end effectors
from Hamilton St. Joseph's Healthcare

reduced costs resulting from earlier discharge of patients from the hospital.

Benefit to society; earlier return to full activity of its citizens.

In the North Bay/Hamilton demonstration Dr. Anvari a leading researcher in the area of Advanced Laproscopic Surgery at St. Joseph's Health Care in Hamilton worked together with Dr. McKinley, taking responsibility for some of the surgerical procedures by controlling the robotic end effector from his operating control station in Hamilton. In an actual mentoring situation both surgeon and mentor could see the same view of the patient and discuss which steps would be required next. Some steps could be controlled locally under the observation and supervision of the mentor and others could be controlled directly by the mentoring surgeon so that the local surgeon could observe and learn.

We asked Dr. McKinley what in his view were the barriers to progress, "One issue is the cost of the bandwidth, we require a large amount of bandwidth as well we take up the highest priority on the network. Our 'phone bill' could be tens of thousands of dollars per month. The other issue is the equipment. In Ball Park numbers the robotic equipment could cost $1M on our end, however the next generation of equipment should be more reliable and more affordable."

Advanced Laproscopic Surgery represents the future of surgery as well as a revolution in the quality and cost of delivering surgical procedures.

Q: When will this technique be coming to a hospital near you?

A: Only when surgeons can be trained through a mentoring process that today requires that they work in a major teaching hospital within a large urban centre. Once trained you will need to lure these talented and ambitious professionals to your community with the prospect of offering them the opportunity to continue their career development in virtual professional isolation. ..... Good luck.

The telesurgery technology demonstrated by St.Joseph's Health Care and North Bay General Hospital on the other hand shows how we can create a career path for your community surgeon that will allow them to keep themselves and your community hospital abreast of the best that surgical medicine has to offer.


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