Feasibility and Implementation of Remote Surgical Telementoring in Rural Hospitals: A Multi-Institutional Case Series

Despite the growing adoption of remote surgical telementoring, issues with network infrastructure and the selection of suitable cases remain underexplored. This study aims to evaluate the feasibility of remote surgical telementoring by assessing the network environment of rural hospitals, identifying appropriate surgical cases and mentee profiles, and exploring practical implementation challenges.

From September 2024 to April 2025, seven cases of remote surgical telementoring were conducted across four rural hospitals. The network environment of each hospital was assessed prior to surgery. Postoperatively, a questionnaire was administered to surgeons, assistants, and observers. The procedures included three sigmoid colectomies and four cholecystectomies, all of which were performed laparoscopically.

Network speeds varied significantly across hospitals, with Hospital A showing poor performance (10 Mbps download, 8 Mbps upload). At Hospital A, sufficient surgical telementoring could not be conducted due to issues such as video and audio interruptions; therefore, it was excluded from the questionnaire survey. Seventy-five percent of the respondents indicated that there was no difference between remote and on-site instruction, and 75% expressed interest in the future use of remote surgical telementoring on the basis of the questionnaire results. Additionally, 70% of the respondents indicated that moderate-complexity surgeries by mid-level surgeons were most suitable for remote surgical telementoring.

Remote surgical telementoring is feasible and effective in hospitals with a reliable network environment and is particularly suitable for moderate-complexity procedures performed by mid-level surgeons.