Design and implementation of a web-based system for intraoperative consultation.

Background: With the use of electronic information distribution and telecommunication technologies, surgical teleconsultation is possible as a vehicle for consulting with experts remotely without their physical presence in the operating room (OR). This study evaluated real-time teleconsultation from the OR to remote consultants in the Russian Research Center of Surgery, Moscow, Russia and the Fundeni Clinical Hospital, Bucharest, Romania.

Methods: We evaluated the effectiveness of teleconsultation using a secure website interface where consultants could navigate through multimedia-based electronic documentation of a surgical procedure and identify the anatomic landmarks underlying the need for consultation. Additionally, management of a remote camera view by consultants was evaluated.

Results: Fifteen thyroidectomies and parathyroidectomies were studied to confirm by teleconsultation the identity of 22 recurrent laryngeal nerves (RLNs). There was no Internet connectivity interruption or dropped signal, and the bandwidth was consistently greater than 1 Mbps. Consultants spent an average of 6 min to review an average of 35 min of surgical records to identify the 22 RLNs.

Conclusions: This study validated a system for real-time teleconsultation using web-based surgical records. In addition, the ability of the consultant to manage the camera view remotely without interrupting the surgical procedure was confirmed.