Telesurgery: remote knowledge translation in clinical surgery

Dissemination of new surgical knowledge, skills, and techniques across the wide spectrum of practicing surgeons in the community is often difficult and slow. This is even more problematic in countries such as Canada, where geographic distances separate a large portion of community surgeons from the large teaching centers. As an example, the penetration of advanced minimally invasive techniques in Canada has been severely hampered by the inability to provide adequate training opportunities and support for community surgeons, many of whom live in remote regions of the country. In an attempt to overcome the barriers that exist, the Centre for Minimal Access Surgery (CMAS) at McMaster University has been using broadband Internet and telecommunication systems to provide distance training and mentoring to community surgeons living in remote northern communities of Canada. This article describes our experience with telementoring and robot-assisted remote telepresence surgery and assisting, between a teaching hospital in Hamilton and two community hospitals in northern Ontario and Quebec.