Initial Experience of Telementoring Using the Intuitive Telepresence® Systems for Robot-Assisted Radical Prostatectomy

Abstract

Background:

Although robotic procedure has become increasingly prevalent, access to experienced surgeons remains challenging. Telementoring offers a potential solution by providing remote guidance to trainees. However, its safety and efficacy in robot-assisted radical prostatectomy (RARP) require further investigation.

Methods:

This prospective observational study evaluated the safety and feasibility of telementoring in RARP using the Intuitive Telepresence platform®. Seven trainees guided by an expert surgeon performed RARP in 23 patients. This study focused on two initial steps: (1) bladder takedown and (2) seminal vesicle dissection. Trainee performance was assessed using the Global Evaluative Assessment of Robotic Skill (GEARS) and objective outcomes, such as blood loss and complications.

Results:

Telementoring was safely implemented in all 23 RARP cases, including those with cT3 disease, with minimal blood loss and no need for mentor intervention at the console during trainee-led procedures. One instance of unstable communication speed did not significantly affect the operation. The GEARS total score had a median of 18.0 (9–25) for trainees and 22.0 (11–28) for mentors. Mentors’ GEARS scores were significantly higher than trainees’ scores (p = 0.021). Trainees tended to underestimate their performance. Mentors scored significantly higher in efficiency (p = 0.034) and force sensitivity (p = 0.003) on the GEARS assessment.

Conclusions:

This study demonstrates the feasibility of telementoring for initial RARP steps using the Intuitive Telepresence platform. Further studies are warranted to evaluate the efficacy of telementoring for more complex procedures and to investigate its impact on long-term surgical outcomes.