Telesurgery--an efficient interdisciplinary approach used to improve the health care system

Abstract

At the time of the writing of this article, there are three operational telemedicine control centers in Bucharest, Targul-Mures, and Iasi; however, the current telemedicine infrastructure has limited geographic coverage and is exclusively used in the field of emergency medicine with only few promising beginnings in the domain of family medicine. Nevertheless, many areas of Romania are still lacking qualified medical personnel that can perform vital surgeries thus requiring patients to travel long distances to obtain the health care services they require. In order to improve the current healthcare infrastructure and eliminate the difficulties associated with a lack of qualified medical personnel in rural areas of the country, this article suggests the implementation of telesurgery as a practical solution. This article will hope to analyze the applicability of telesurgery by looking at the benefits and costs of creating a national telesurgery infrastructure, by predicting possible obstacles in creating such a system and by suggesting ways in which these obstacles can be avoided. The writing of this article was possible thanks to interviews, articles, and data obtained from surgeons and medical personnel that practice in Romania, the Republic of Moldova, Canada, and the United States of America. A vast majority of technical details has been furnished by the producers of robotic surgery platforms such as Intuitive Surgical®.

Keywords: Asynchronous transfer mode; Telesurgery; virtual private network.

Fig. 1

Examples of long-term consequences of the lack of a telesurgery system

Fig. 2

Telesurgical infrastructure in Romania. In the above image, every flag represents a telemedicine control station that can be equipped with the necessary equipment to conduct telesurgery. Every control station is placed strategically to allow a maximal coverage of Romania.

Fig. 3 A,B

Telemedicine system used by Dr. David A. Vitberg, MD, in the Critical Care Services, GBMC, Baltimore, Maryland. Clinical Assistant Professor, Department of Emergency Medicine, University of Maryland School of Medicine, Associate Medical Director, Baltimore County Fire Department. Images reproduced with the permission of Dr. David A. Vitberg.