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. 2024 Dec 20;28(3):111653.
doi: 10.1016/j.isci.2024.111653. eCollection 2025 Mar 21.

Development and evaluation of an international teleproctoring program for bronchoscopic procedures

Francesca M Conway  1   2   3 , Anand Tana  1   2   3 , Cielito Caneja  1   2 , James Tonkin  1   2 , Laura Avanzi  2 , Justin Garner  1   3 , Christopher M Orton  1   2   3 , Karthi Srikanthan  4 , Ley Chan  1   2   3 , John Thornton  2   3 , Rainer Joachim  5 , Virgile Donet  5 , Philip J Johnson  5 , Pallav L Shah  1   2   3
Affiliations

Development and evaluation of an international teleproctoring program for bronchoscopic procedures

Francesca M Conway et al. iScience. .

Abstract

Medical procedures often require proctoring that is traditionally done face-to-face, but this poses a significant carbon footprint and logistical challenges. Little is known about the safety and efficacy of remote "tele"proctoring, particularly in the respiratory field. The aim was to develop, implement, and evaluate a teleproctoring program for bronchoscopy procedures. Seventy-eight targeted lung denervation procedures were performed at UK hospitals; 20 with teleproctoring, with real-time multimodality data streaming to an off-site proctor; and 58 with on-site proctoring. Procedure completion, procedure duration (bronchoscopy, anesthetic, and fluoroscopy), and safety outcomes (adverse events and device deficiencies) were compared between groups. Teleproctoring offered a safe alternative to on-site proctoring, with little difference in completion rates, procedure durations or safety outcomes. Teleproctoring could be a cost-effective, sustainable and efficient alternative to face-to-face proctoring in appropriate centers. Further work could expand this system to allow remote expert advice to facilitate procedures in clinical practice, and for procedural teaching.

Keywords: Respiratory medicine; Surgery; Surgical procedure.

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Conflict of interest statement

Institution: Royal Brompton Hospital and Chelsea and Westminster Hospital have been reimbursed for clinical trial expenses (Airflow 3 Trial). F.M.C. has received a pre-doctoral fellowship from the medical research council to support her PhD, which is relevant to this work. P.J.J., R.J., and V.D. are paid employees of Nuvaira.

Figures

None
Graphical abstract
Figure 1
Figure 1
Images of equipment for TLD procedure (A) TLD console connected to catheter. (B) TLD catheter. (C) Close up of the balloon and electrode on the TLD catheter.
Figure 2
Figure 2
Search strategy for literature review
Figure 3
Figure 3
Endobronchial image screenshot from the teleproctor’s screen (A) This is an image of the endobronchial view from the bronchoscope camera as seen on the teleproctor’s screen. The teleproctor has a clear view of the entire bronchoscopy screen, including the patient’s airways, and the balloon and electrode of the catheter. This is the same view that is seen by the on-site treating physician team. Image not to scale. (B) Fluoroscopy image screenshot from the teleproctor’s screen. This is an image of the fluoroscopy view projected within the bronchoscopy suite and to the teleproctor. The X-ray of the patient’s chest is well visualized including the bronchoscope and the contrast-filled balloon within the esophagus. (Image not to scale. Image has been cropped to anonymize it).
See this image and copyright information in PMC

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