Development of a new telementoring program.

he last decade has witnessed a rapid growth in both the number and complexity of laparoscopic surgical procedures. This trend towards increased practice of minimally invasive surgical procedures is expected to continue, with those in the field predicting that by the end of the next decade approximately 70% of all surgical procedures will be treated laparoscopically. At the heart of this growth in popularity are two issues – cost of care and patient satisfaction with the result of the surgery. Despite the large capital costs initially required to obtain the necessary equipment, many have found that practising laparoscopic surgery actually reduces the costs of patient care. These cost savings are centred around the shorter in-hospital recovery times and lower rates of complications resulting from these procedures. Increased patient satisfaction has also been noted with the practice of minimally invasive procedures, primarily derived from shorter recovery, fewer complications, and better cosmetic results. Both of these factors are driving the need for these procedures ever higher, encouraging many surgeons to seek out the training required for practice. Unfortunately, these skills cannot be easily acquired in the classroom setting, despite the necessity of this format for acquisition of basic anatomical and surgical knowledge. The Society of American Gastrointestinal Endoscopic Surgeons (SAGES) recommends that in addition to didactic and simulated cadaver practice, all surgeon learners should undergo a period of mentoring or supervisory practice (Surgical Endoscopy, 1997, 11: 789-92). While this is not a bona fide requirement, many institutions and individuals have recognized the value of supervised practice and therefore, undertake to acquire this experience before attempting independent practice. To meet this national requirement for mentoring, the Centre for Minimal Access Surgery (CMAS) based at St. Joseph’s Hospital in Hamilton, Ontario, is in the process of developing a mentoring and telementoring program for minimally invasive, laparoscopic procedures. This program is due to be implemented in the summer of 2000.