Laparoscopic Applications

Despite the shortcomings outlined above, telemedicine and even telesurgery have become a reality. Kavoussi and coworkers in 1994 demonstrated their initial laboratory experience in telerobotic-assisted laparoscopic surgery (54-59). Recently, urologic

As one looks forward into the 21st century, the future of telemedicine looks brighter.

Technological improvements lowering the cost of imaging devices and the cost of utilizing specialized telecommunications lines will make telemedicine systems even more affordable than they are today and greatly enhance the performance of laparoscopic procedures in urology.

Several studies dies have identified significant stressors to the surgeon induced by laparoscopy, including monitor placement, camera holding, trocar placement, and table position and height.

Robotics and head-mounted displays are other recent advancements effecting surgeon comfort.

The development of laparoscopic instruments with endowrist capabilities will further bridge the gap between robotics and pure laparoscopy.

laparoscopic telesurgery has been performed in a clinical setting. In this study, five patients in Rome, Italy, underwent laparoscopic procedures in a center where laparoscopy was only recently introduced (60). Nine thousand kilometers away in Baltimore, United States, a more experienced team oversaw the procedures in real time, offered advice, provided quality control, and even operated instruments remotely. The cases performed included a laparoscopic nephrectomy. This revolutionary approach to telemedicine has opened the door for more widespread applications of laparoscopic techniques, enhanced training, and improved patient care.

As one looks forward into the 21st century, the future of telemedicine looks brighter. Advances in digital imaging resolution and improvements in transmission bandwidth will make telesurgery and decision-making through telemedicine more accurate.

Technological improvements lowering the cost of imaging devices and the cost of utilizing specialized telecommunications lines will make telemedicine systems even more affordable than they are today and greatly enhance the performance of laparo-scopic procedures in urology (54,59,61,62).

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