By SARI HUHTALA
A convergence of technologies is driving new paradigms at North Bay General Hospital where lead surgeons are assessing the feasibility of telementoring in the medical field.
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High bandwidth telecommunications is finding its place in operating rooms, and North Bay General Hospital is leading the way in Canada and North America using revolutionary technologies, says Dr. Craig McKinley, a general surgeon practicing in North Bay.
The ideology behind telementoring is to bring big-city surgical expertise to small-town Canada, McKinley points out.
McKinley and Dr. Susan Hegge, who is also a general surgeon at the hospital, are both experts in laparoscopic surgery, and plan on performing about 15 more telementoring surgeries using the laparascopic method over the next month or two in order to assess the feasibility of the telementoring technique.
Laparoscopic surgery, surgery which is performed with the use of a small camera inserted into the abdomen, was first introduced in the medical field over a decade ago for surgical removal of a gall bladder. And, while its benefits to both the hospital and patient are widespread, traditional large-incision intra-abdominal surgeries still continue to dominate the operating room.
However, for the past four years, McKinley and Hegge have expanded their expertise in laparoscopic surgery to apply the technique to all intra-abdominal surgeries with the intent on transitioning general surgeons to the laparoscopic method.
"Less than 10 per cent of surgeons in North America would practice the way we do using the laparoscopic approach to do major intra-abdominal surgery," McKinley says.
With the laparoscopic approach, some patients are able to return home from the hospital on the same day as the surgery and be back to full activity in a week, he notes.
Telementoring is simply a natural extension of laparoscopic surgery, McKinley points out.
Images from the camera, which is inserted into the abdomen, are displayed on a television monitor in the operating room and an expert surgeon makes comments based on the images. In telementoring, an expert surgeon can view the operation in real time anywhere in the world and the fibre optics allows two-way communications to take place.
The hospital's first telementoring surgery took place on Dec. 14, 2002, and they now have four surgeons performing this type of surgery in North Bay.
"We have done several telementoring procedures, and in the initial experience we've had, it has been useful and a positive addition to the repertoire of abilities we can bring to the operating room," McKinley says.
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DR. CRAIG MCKINLEY |
The telementoring program is funded by a Health Canada Infrastructure Program (CHIP) grant, which was acquired by Dr. Mehan Anvari at the Centre for Minimal Access Surgery in Hamilton. North Bay is the pilot site for telementoring in Ontario, and there are two other sites in Canada - one in Quebec and one in the Northwest Territories. North Bay is by far the most progressive telementoring site in the nation, McKinley says.
"We would likely be the most active institution in Canada, and possibly North America, even possibly the world, when it comes to assessing the role of telementoring in the operating room in advanced laparoscopic procedures," McKinley says.
The future role of this technology is to enable community surgeons to deliver state-of-the-art surgical care to patients at their local hospitals.
"We hope that by creating an active telementoring program and demonstrating the feasibility of this technology we would be able to further the repertoire of advanced laparoscopic surgeries performed here in North Bay and in the North, and in all community hospitals," McKinley says.
Ontario is in a unique position to use this technology because of the investment the provincial government has made in capital infrastructure, which has connected every hospital in Ontario to high-speed networks, he points out.
