# Surgical Education, Telementoring and Devices — GCMD Library living collection

Updated: n/a · 10 episodes · 82 cited statements

## Episodes
### Telementoring, training and safe practice
- [Telementoring symposium introduction: Comparative Technology in Telementoring...](https://library.globalcastmd.com/watch/telementoring-symposium-introduction-comparative-technology-in-telementoring-978) — video · 6:33 · [machine version](https://library.globalcastmd.com/watch/telementoring-symposium-introduction-comparative-technology-in-telementoring-978.md)
- [Surgical Skill Acquisition in the Modern Era: Comparative Technology in...](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979) — video · 13:39 · [machine version](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979.md)
- [Surgical telementoring-emerging technologies: Comparative Technology in...](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966) — video · 30:18 · [machine version](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966.md)
- [Telementoring panel discussion: Comparative Technology in Telementoring 2016](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965) — video · 13:17 · [machine version](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965.md)
- [Mentoring+Technology+Progression-HD](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942) — video · 4:36 · [machine version](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942.md)
- [SAGES Telemedicine](https://library.globalcastmd.com/watch/sages-telemedicine-11963) — article · [machine version](https://library.globalcastmd.com/watch/sages-telemedicine-11963.md)
- [Telementoring Vail 2015](https://library.globalcastmd.com/watch/telementoring-vail-2015-11972) — article · [machine version](https://library.globalcastmd.com/watch/telementoring-vail-2015-11972.md)

### Instruments, energy and robotics
- [Laparoscopic Mesenteric and Short Gastric Dissection with a Vessel Sealer](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997) — video · 3:16 · [machine version](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997.md)
- [Thoracoscopic Vessel Sealing with LigaSure](https://library.globalcastmd.com/watch/thoracoscopic-vessel-sealing-with-ligasure-11933) — video · [machine version](https://library.globalcastmd.com/watch/thoracoscopic-vessel-sealing-with-ligasure-11933.md)
- [KSE ASENSUS](https://library.globalcastmd.com/watch/kse-asensus-11925) — article · [machine version](https://library.globalcastmd.com/watch/kse-asensus-11925.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=0) Google Glass Technology Assessment (Ep 4)
- [3:04](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=184) Virtual Mentorship Models and Audience Questions (Ep 4)
- [5:15](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=315) Educational Frameworks and Surgeon Shortage (Ep 4)
- [7:22](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=442) Implementation Barriers and Cultural Change (Ep 4)
- [10:45](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=645) Research Strategy and Medical-Legal Concerns (Ep 4)
- [0:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=0) Introduction to Project 6 and Surgical Telementoring Fundamentals (Ep 3)
- [4:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=240) Telestration and Data Security Requirements (Ep 3)
- [8:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=480) Skype for Business Platform Review (Ep 3)
- [12:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=720) Remote Desktop Software Platforms (Ep 3)
- [16:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=960) Cleveland-Norway Telementoring Experience and On-Site Collaboration Platform (Ep 3)
- [19:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=1140) Upsurge, OR Network, STAR Platform, and Low-Cost Indian System (Ep 3)
- [20:49](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=1249) Discussion: Practical Challenges and Future Directions (Ep 3)
- [26:45](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=1605) Defining Surgical Telementoring vs Telemedicine (Ep 3)
- [0:00](https://library.globalcastmd.com/watch/telementoring-symposium-introduction-comparative-technology-in-telementoring-978?t=0) Welcome and symposium overview (Ep 1)
- [3:09](https://library.globalcastmd.com/watch/telementoring-symposium-introduction-comparative-technology-in-telementoring-978?t=189) Faculty introductions (Ep 1)
- [0:00](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=0) Historical context of surgical education and the apprenticeship model (Ep 2)
- [3:00](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=180) The five-step skill acquisition model (Ep 2)
- [5:00](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=300) Early telementoring experiences and technology evolution (Ep 2)
- [8:00](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=480) Advanced telestration technology and international telementoring (Ep 2)
- [11:00](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=660) The Akron-Tromsø project and implementation barriers (Ep 2)
- [0:10](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=10) Vessel dissection and clip placement technique near diaphragm (Ep 5)
- [0:59](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=59) Port placement and pyloric measurement technique (Ep 5)
- [1:30](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=90) Umbilical anatomy and suture placement technique (Ep 5)
- [2:23](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=143) Differential diagnosis question regarding cystic lesion (Ep 5)
- [2:38](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=158) Superior segmentectomy technique and cyst dissection (Ep 5)
- [4:29](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=269) Case conclusion (Ep 5)
- [0:00](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=0) Intestinal duplication mesentery takedown technique (Ep 8)
- [1:15](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=75) Safety advantages over electrocautery in pelvic dissection (Ep 8)
- [2:10](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=130) Nissen fundoplication in post-NEC infant and Hirschsprung's application (Ep 8)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- Google Glass has been off the market for approximately one year as of this discussion — Brian (clinical) [Ep 4 · 0:06](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=6)
- Google Glass form factor allows wireless 3G/4G connectivity without fixed room infrastructure — Brian (clinical) [Ep 4 · 0:30](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=30)
- Google Glass cannot effectively illustrate tissue planes and enable fine telestration detail for surgical guidance on where to dissect and cut — Brian (clinical) [Ep 4 · 1:30](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=90)
- Google Glass battery life was approximately 15 minutes for recording or operative use — Brian (clinical) [Ep 4 · 2:30](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=150)
- Heat buildup on the head was a limitation of Google Glass during extended use — Brian (clinical) [Ep 4 · 2:30](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=150)
- Pristine company stripped down Google Glass operating system to extend battery life and decrease heat buildup — Brian (clinical) [Ep 4 · 2:50](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=170)
- For meaningful surgical cases, Google Glass required wired connection to external battery pack — Brian (clinical) [Ep 4 · 2:50](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=170)
- Lower fidelity but more scalable technology may be appropriate for later stages of progressive surgical training after initial observation and supervised cases — Brian (opinion) [Ep 4 · 1:30](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=90)
- Europe will face a similar surgeon shortage to the United States — Knut (opinion) [Ep 4 · 6:30](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=390)
- Surgical telementoring may decrease the length of surgical education — Knut (opinion) [Ep 4 · 6:30](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=390)
- To become board certified in the United States, surgeons must take written or oral tests, but no one checks if they are good surgeons — Todd Ponsky (clinical) [Ep 4 · 7:00](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=420)
- The American Board of Surgery originally included observation of surgeons operating in their examination process — Steve (clinical) [Ep 4 · 7:22](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=442)
- Surgeon mentality is one of the biggest hurdles to telementoring adoption, including reluctance to show weakness or ask for help — Todd Ponsky (opinion) [Ep 4 · 7:33](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=453)
- Having a mentor or advisor physically present in the operating room improves patient outcomes — Todd Ponsky (clinical) [Ep 4 · 8:10](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=490)
- Policymakers view telemedicine primarily as direct patient interaction for care delivery and do not understand telementoring as a quality initiative — Brian (opinion) [Ep 4 · 9:26](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=566)
- There is a lack of good quality studies on surgical telementoring due to logistical obstacles and cumbersome technology — Knut (epidemiological) [Ep 4 · 10:45](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=645)
- An international surgical quality registry for telementoring cases could generate meaningful evidence in 10 years rather than through small series of 10-20 cases — Knut (opinion) [Ep 4 · 11:20](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=680)
- Medical-legal concerns and fear prevent widespread telementoring adoption and limit case volume for research — Todd Ponsky (opinion) [Ep 4 · 11:56](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=716)
- Licensing and credentialing frameworks must be established before surgeons will feel comfortable performing telementored cases at scale — Todd Ponsky (opinion) [Ep 4 · 12:10](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=730)
- Telestration reduces errors by more than 30% in surgical telementoring (clinical) [Ep 3 · 4:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=240)
- Skype for Business is approved by Scandinavian authorities for medical use but not yet HIPAA compliant in the United States (guideline) [Ep 3 · 8:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=480)
- Most remote desktop systems require a separate line for audio, which can be a challenge (clinical) [Ep 3 · 15:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=900)
- The STAR platform can be used for open surgery but not yet for laparoscopic surgery (clinical) [Ep 3 · 19:40](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=1180)
- When using laparoscopic video for telestration, if the camera holder moves the camera, the telestration lines move and no longer correspond to the anatomy (clinical) [Ep 3 · 23:40](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=1420)
- Telementoring is challenging time-wise because watching someone perform a 3-hour operation requires significant mentor availability unless structured as on-call consultation (opinion) [Ep 3 · 23:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=1380)
- Surgical telementoring requires three elements: a known mentor-mentee relationship, an educational framework (not teleconsultation), and local surgical expertise to manage the disease process (guideline) [Ep 3 · 27:30](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=1650)
- Integrating telementoring into structured training programs may be one of the keys to successful implementation (opinion) [Ep 3 · 23:20](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=1400)
- Telementoring is particularly valuable in geographically large areas like Norway, Africa, and the US where surgeons may not have enough experience with specific techniques (opinion) [Ep 3 · 22:20](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=1340)
- Educational experts outside surgery can help inform best practices for teaching over distance and using telementoring platforms (opinion) [Ep 3 · 27:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=1620)
- The traditional surgical apprenticeship model involves three stages: expert performs while trainee watches, trainee performs with expert watching carefully, and trainee performs almost autonomously with minimal oversight (clinical) [Ep 2 · 1:25](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=85)
- The skill acquisition model consists of five steps: course attendance, trainee observes expert, trainee performs with expert watching, telementoring, and teleproctoring (clinical) [Ep 2 · 3:20](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=200)
- Telementoring should be introduced at step 4 of the skill acquisition model, not at step 1 (opinion) [Ep 2 · 4:00](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=240)
- Virtual courses allow surgeons to learn without traveling, using the internet in ways that make sense (opinion) [Ep 2 · 4:20](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=260)
- The first telementoring case used Skype for a baby requiring lung resection, with verbal pointing only and no telestration capability (clinical) [Ep 2 · 5:00](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=300)
- Verbal pointing without telestration was really difficult for guiding surgical procedures remotely (opinion) [Ep 2 · 5:35](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=335)
- The Visitor One solution provides robust telestration capability with integrated drawing features (clinical) [Ep 2 · 5:45](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=345)
- The Norwegian group (Etai Bogen and colleagues) developed an off-the-shelf telestration solution using Androids and iPads (clinical) [Ep 2 · 6:40](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=400)
- The surgeon performing the operation must be capable of completing it independently because technology may fail or internet connection may be lost (opinion) [Ep 2 · 8:20](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=500)
- The mentor should provide tips and tricks but not serve as a crutch for the operating surgeon (opinion) [Ep 2 · 8:35](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=515)
- An emergency 'break the glass' telementoring model could help non-pediatric trauma centers manage unstable pediatric trauma patients who cannot be transferred (opinion) [Ep 2 · 8:50](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=530)
- The emergency co-pilot or virtual first assistant model is debated because it involves guidance from someone the surgeon has never met before, without prior relationship (opinion) [Ep 2 · 9:15](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=555)
- Brian has been the leader in defining how to incorporate telementoring into the educational training model (opinion) [Ep 2 · 9:40](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=580)
- The staged skill acquisition model (course, expert performs, trainee performs with expert present, then telementoring) is becoming the more accepted approach (opinion) [Ep 2 · 9:50](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=590)
- Key barriers to telementoring implementation include medical-legal issues, licensing, credentialing, technology costs, and compensation for expert time (opinion) [Ep 2 · 10:10](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=610)
- For global-scale telementoring, experts will need justification for not spending time in their own operating rooms, suggesting volunteer goodwill alone is insufficient (opinion) [Ep 2 · 10:35](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=635)
- Project 6 and the American College of Surgeons Education Committee (David Hoyt and Sadiva) are actively pushing telementoring initiatives (clinical) [Ep 2 · 10:55](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=655)
- Demand for telementoring has come primarily from rural surgeons working alone who want assistance without sending all patients to tertiary centers (epidemiological) [Ep 2 · 11:10](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=670)
- Polling of rural surgeons confirmed they want telementoring services (epidemiological) [Ep 2 · 11:20](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=680)
- The Akron-Tromsø project tested whether laparoscopic non-mesh hernia repair could be taught using the complete skill acquisition model (clinical) [Ep 2 · 11:40](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=700)
- The Akron-Tromsø project was led by Knut, Etai Bogan, and Ralph Ole (clinical) [Ep 2 · 11:50](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=710)
- Peter Gessing is a talented general surgeon in Tromsø who also performs pediatric surgery (clinical) [Ep 2 · 12:10](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=730)
- The Akron-Tromsø project progression included: virtual course viewing, in-person demonstration by expert, trainee performing with expert present, telementoring with expert in same building, and finally telementoring from across the ocean (clinical) [Ep 2 · 12:00](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=720)
- The final telementoring session occurred at 3 AM (speaker's time) for a full day of cases in Tromsø using iPad drawing system (clinical) [Ep 2 · 12:55](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=775)
- True skill acquisition of new surgical techniques requires more than a simulation course or lecture alone (opinion) [Ep 2 · 13:20](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=800)
- Virtual presence can facilitate skill acquisition but must be an element of a robust model where a relationship is established and both parties become comfortable with each other (opinion) [Ep 2 · 13:30](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=810)
- The sealer is used to take down mesentery of intestinal duplication by sealing vessels and dissecting underneath the anti-mesentery border for stapler placement. (clinical) [Ep 8 · 0:00](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=0)
- This mesenteric sealing and retraction technique is used in all bowel resections. (clinical) [Ep 8 · 0:30](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=30)
- Vessels are individually isolated, grasped with the sealer, sealed, and retracted away from the bowel. (clinical) [Ep 8 · 0:50](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=50)
- This technique is very safe and efficient for mobilizing distal bowel without devascularizing it. (opinion) [Ep 8 · 1:05](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=65)
- The sealer is much safer than electrocautery in pelvic areas because electrocautery can spread to surrounding structures causing injury to vas deferens, bladder, ureter, and other structures. (clinical) [Ep 8 · 1:15](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=75)
- Electrocautery could also damage the bowel itself in this area. (clinical) [Ep 8 · 1:40](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=100)
- The ability to dissect, seal, and distract tissues away from the colon provides a very safe and efficient technique. (opinion) [Ep 8 · 1:45](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=105)
- The 3 millimeter sealer can be used to seal and separate thicker tissue planes. (clinical) [Ep 8 · 2:00](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=120)
- Previous perforated NEC causes significant adhesions in the upper abdomen from inflammation. (clinical) [Ep 8 · 2:10](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=130)
- Short gastric vessels are 1 to 2 millimeters in size and are perfect for creating a double seal and then distracting the vessels apart. (clinical) [Ep 8 · 2:40](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=160)
- The sealer allows use of both hands for retraction at all times without needing to interchange for scissors. (clinical) [Ep 8 · 2:55](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=175)
- It would have been extremely difficult to perform this maneuver having to interchange for scissors or with an instrument that could not readily manipulate small and delicate tissues. (opinion) [Ep 8 · 3:05](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=185)
- The sealer provides easy control of both stomach and spleen and can seal and separate short gastrics with little trauma to surrounding tissues. (clinical) [Ep 8 · 3:15](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=195)
- The same sealing technique can be used in Hirschsprung's disease to dissect mesentery right off the bowel wall. (clinical) [Ep 8 · 3:40](https://library.globalcastmd.com/watch/laparoscopic-mesenteric-and-short-gastric-dissection-with-a-vessel-sealer-11997?t=220)
- Dividing tissue will free up the lower lobe and help pull it away to maximize length — Steve (clinical) [Ep 5 · 0:10](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=10)
- Clips should be placed as close to the diaphragm as possible while maximizing vessel length — Steve (clinical) [Ep 5 · 0:10](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=10)
- Using more of the instrument tip allows better visualization of the vessel itself — Steve (clinical) [Ep 5 · 0:10](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=10)
- Standard technique is to measure 10 centimeters up from the pylorus using 10 centimeter silk — Todd (clinical) [Ep 5 · 0:59](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=59)
- The G-tube location typically corresponds to approximately 10 centimeters from the pylorus — Todd (clinical) [Ep 5 · 0:59](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=59)
- After placing a suture loop, grasping the peritoneum with Maryland forceps and pulling up on the loop can reposition the suture — Steve (clinical) [Ep 5 · 1:30](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=90)
- The differential diagnosis for the cystic lesion includes whether it represents two elements or a bronchogenic cyst — Bob (clinical) [Ep 5 · 2:23](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=143)
- A superior segment resection is feasible based on the anatomical findings — Steve (clinical) [Ep 5 · 2:38](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=158)
- Unroofing the top of the cyst and carrying the dissection back allows visualization of how it separates from upper lobe vessels — Steve (clinical) [Ep 5 · 2:38](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=158)
- The superior segment artery is expected to be located within the dissection plane near the cyst — Steve (clinical) [Ep 5 · 2:38](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=158)
- Lymph nodes in the area need to be removed to facilitate the dissection — Steve (clinical) [Ep 5 · 2:38](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=158)
- After taking the artery, a dissection plane will become apparent — Steve (clinical) [Ep 5 · 2:38](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=158)
- Vessel control can be achieved with either an endo-loop or clips — Steve (clinical) [Ep 5 · 2:38](https://library.globalcastmd.com/watch/mentoring-technology-progression-hd-11942?t=158)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- 64% of audience poll respondents believe the mentor should not have a prior relationship with the patient — Todd Ponsky summarizing the discussion [Ep 4 · 4:10](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=250)
- A recently published paper projects a shortage of 2,000 to 3,000 general surgeons in the United States within a few years — Knut summarizing the discussion [Ep 4 · 6:00](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=360)
- Residents finishing residencies need mentoring in their first two years of independent practice — Todd Ponsky summarizing the discussion [Ep 4 · 6:48](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=408)
- Patient outcome is directly related to surgeon technical ability — Brian summarizing the discussion [Ep 4 · 10:00](https://library.globalcastmd.com/watch/telementoring-panel-discussion-comparative-technology-in-telementoring-2016-965?t=600)
- A Houston-Melbourne collaboration successfully telementored 25 retroperitoneoscopic adrenalectomy cases using Skype, concluding it is a feasible platform — The host summarizing the discussion [Ep 3 · 9:40](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=580)
- The first published study on remote desktop systems for surgical telementoring was by Gambadero and Marcus in London in 2007 for laparoscopic gynecological surgery — The host summarizing the discussion [Ep 3 · 13:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=780)
- The OR Network platform has telementored 500 laparoscopic procedures from the United Kingdom to Tanzania — The host summarizing the discussion [Ep 3 · 18:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=1080)
- The STAR (System for Telementoring with Augmented Reality) platform allows participants to complete tasks with fewer placement errors and fewer focus shifts by overlaying transparent telestration directly on the surgical field — The host summarizing the discussion [Ep 3 · 19:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=1140)
- Indian colleagues created a surgical telementoring setup using a repurposed laparoscopic camera for video capture at a cost of only $400-500 — The host summarizing the discussion [Ep 3 · 20:00](https://library.globalcastmd.com/watch/surgical-telementoring-emerging-technologies-comparative-technology-in-966?t=1200)
- Telementoring is the idea that one expert surgeon can beam into another surgeon's room and help guide them through an operation. — Todd Ponsky summarizing the discussion [Ep 1 · 0:00](https://library.globalcastmd.com/watch/telementoring-symposium-introduction-comparative-technology-in-telementoring-978?t=0)
- There is debate about whether telementoring will be used in emergency situations or as part of education. — Todd Ponsky summarizing the discussion [Ep 1 · 1:00](https://library.globalcastmd.com/watch/telementoring-symposium-introduction-comparative-technology-in-telementoring-978?t=60)
- Karl Storz Endoscopy has been a leader in creating the technology used for telementoring. — Todd Ponsky summarizing the discussion [Ep 1 · 1:30](https://library.globalcastmd.com/watch/telementoring-symposium-introduction-comparative-technology-in-telementoring-978?t=90)
- 49 countries are joining the symposium with over 200 hospitals participating. — Todd Ponsky summarizing the discussion [Ep 1 · 2:00](https://library.globalcastmd.com/watch/telementoring-symposium-introduction-comparative-technology-in-telementoring-978?t=120)
- Dr. Knut Augustad wrote one of the original papers on telementoring. — Todd Ponsky summarizes what Dr. Knut Augustad said [Ep 1 · 2:30](https://library.globalcastmd.com/watch/telementoring-symposium-introduction-comparative-technology-in-telementoring-978?t=150)
- Dr. Brian Duncan, as past president of SAGES, made telementoring a top priority and catapulted it to the mainstream. — Todd Ponsky summarizes what Dr. Brian Duncan said [Ep 1 · 3:11](https://library.globalcastmd.com/watch/telementoring-symposium-introduction-comparative-technology-in-telementoring-978?t=191)
- Mighty (Methodist Institute for Technology, Innovation and Education) is probably the largest surgical training center in the world. — Todd Ponsky summarizing the discussion [Ep 1 · 3:40](https://library.globalcastmd.com/watch/telementoring-symposium-introduction-comparative-technology-in-telementoring-978?t=220)
- Dr. Steven Rothenberg has been doing telementoring for well over 10 years using multiple different technologies. — Todd Ponsky summarizes what Dr. Steven Rothenberg said [Ep 1 · 4:25](https://library.globalcastmd.com/watch/telementoring-symposium-introduction-comparative-technology-in-telementoring-978?t=265)
- Dr. Steven Rothenberg is one of the pioneers of pediatric minimally invasive surgery. — Todd Ponsky summarizes what Dr. Steven Rothenberg said [Ep 1 · 4:25](https://library.globalcastmd.com/watch/telementoring-symposium-introduction-comparative-technology-in-telementoring-978?t=265)
- Medical knowledge doubles every 18 months according to Brian's earlier statement — The host summarizing the discussion [Ep 2 · 2:00](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=120)
- Sir William Osler established that medical training should include residency, bringing doctors to patients rather than relying solely on lectures — The host summarizing the discussion [Ep 2 · 0:50](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=50)
- Dr. William Halstead, a surgeon, created surgical residency based on Osler's residency concept — The host summarizing the discussion [Ep 2 · 1:10](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=70)
- Telestration lines move when the camera moves during surgery, which is a technical limitation — The host summarizing the discussion [Ep 2 · 7:00](https://library.globalcastmd.com/watch/surgical-skill-acquisition-in-the-modern-era-comparative-technology-in-979?t=420)

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