NEST (network enhanced surgical training): a PC-based system for telementoring in gynaecological surgery

To develop and describe NEST (network enhanced surgical training), an affordable and easily reproducible telementoring system.

We have developed the system around two standard personal computers: a desktop computer for the surgeon in the operating room (OR), equipped with a digital video-capture system; and a laptop computer for a mentor outside the OR. In an attempt to reduce the costs, freeware software has been tested and chosen to allow visual and audio interaction between the two computers. No IT technicians were involved in the process at any stage.

Following 6 months of hardware and software testing, we have successfully developed NEST (network enhanced surgical training), an affordable telementoring system based on two standard personal computers connected through an Ethernet cable. We tried NEST during the whole range of gynaecologic interventions performed in our unit, including abdominal, vaginal and laparoscopic surgery. We also successfully used NEST to provide visual access to the operative field to medical students and endoscopy workshop delegates. In addition, we also used NEST to simulate telementoring during pelvi-trainer sessions in our endoscopy skills laboratory. Surgeons' interaction through NEST seems reliable since the mentor's instructions, both vocal and visual (by pointing at landmarks), were always followed on time by the surgeon during our tests.

We believe that surgical telementoring deserves attention and our NEST system could be an ideal tool for studies on telementoring in safe environments. In its simplest incarnation with the mentor "next-door", just outside the operating theatre, he/she could intervene at any stage if necessary. Moreover, NEST is affordable and reproducible as it is based solely on two standard personal computers, a video-capture system, an Ethernet cable, and two freeware computer programs.