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. 2018 Dec 5;6(12):e1999.
doi: 10.1097/GOX.0000000000001999. eCollection 2018 Dec.

Google Glass for Remote Surgical Tele-proctoring in Low- and Middle-income Countries: A Feasibility Study from Mozambique

Meghan C McCullough  1 , Louie Kulber  2 , Patrick Sammons  1 , Pedro Santos  3 , David A Kulber  1   4
Affiliations

Google Glass for Remote Surgical Tele-proctoring in Low- and Middle-income Countries: A Feasibility Study from Mozambique

Meghan C McCullough et al. Plast Reconstr Surg Glob Open. .

Abstract

Background: Untreated surgical conditions account for one-third of the total global burden of disease, and a lack of trained providers is a significant contributor to the paucity of surgical care in low- and middle-income countries (LMICs). Wearable technology with real-time tele-proctoring has been demonstrated in high-resource settings to be an innovative method of advancing surgical education and connecting providers, but application to LMICs has not been well-described.

Methods: Google Glass with live-stream capability was utilized to facilitate tele-proctoring between a surgeon in Mozambique and a reconstructive surgeon in the United States over a 6-month period. At the completion of the pilot period, a survey was administered regarding the acceptability of the image quality as well as the overall educational benefit of the technology in different surgical contexts.

Results: Twelve surgical procedures were remotely proctored using the technology. No complications were experienced in any patients. Both participants reported moderate visual impairment due to image distortion and light over-exposure. Video-stream latency and connection disruption were also cited as limitations. Overall, both participants reported that the technology was highly useful as training tool in both the intraoperative and perioperative setting.

Conclusions: Our experience in Mozambique demonstrates the feasibility of wearable technology to enhance the reach and availability of specialty surgical training in LMICs. Despite shortcomings in the technology and logistical challenges inherent to international collaborations, this educational model holds promise for connecting surgeons across the globe and introducing expanded access to education and mentorship in areas with limited opportunities for surgical trainees.

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Figures

Video Graphic 1.
Video Graphic 1.
See video, Supplemental Digital Content 1, which displays an example video feed from mentor surgeon’s computer, http://links.lww.com/PRSGO/A910.
Fig. 1.
Fig. 1.
Remote “tele-stration.”
Fig. 2.
Fig. 2.
Excision of a giant cell tumor of the third digit using Google Glass tele-proctoring.
Fig. 3.
Fig. 3.
Perceived degree of impairment due to various image distortions.
Fig. 4.
Fig. 4.
Perceived education value in various surgical contexts.
Fig. 5.
Fig. 5.
Fitting the Google Glass headset over surgical loupes.
Fig. 6.
Fig. 6.
Light-over exposure (A) and correction (B).
Fig. 7.
Fig. 7.
Image parallax and displacement of point of interest within remote viewer’s screen.
See this image and copyright information in PMC

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