Low workload for pelvic neuromonitoring supported by teleconsulting: technical considerations and feasibility
Year: 2025
Type: article
Abstract: BACKGROUND: Pelvic intraoperative neuromonitoring (pIONM) prevents functional disturbances after low anterior rectal resection. We investigated the workload of performing pIONM under telementoring conditions to catalyze translation into surgical practice. METHODS: Six patients with rectal cancer underwent nerve-sparing total mesorectal excision (TME) with laparoscopic or robot-guided pIONM. A telementoring system enables cross-reality interaction, with online communication between a briefed on-site surgeon at the operating room and a remote mentor at an external hospital. The validated NASA Task Load Index (NASA-TLX) was used to measure the workload for standardized pIONM. RESULTS: The pIONM was installed and performed without any problems. It required a median 7 min stimulation time (range 7-10 min) and confirmed nerve-sparing TME in all six patients. Remote and on-site telepresence required a median 31 min (range 24-44 min), enabling adequate application training for a first-time user. The overall NASA-TLX-based workload realizing pIONM was a median 8.7 (range 3.3-16.3) points. There was no significant difference in TLX between on-site and remote surgeons (p = 0.180). Overall workload was highest for the first-time user but decreased upon repetition. Significantly higher values were found in the following subscales for the surgeon performing pIONM: physical demand (p = 0.002) and temporal demand (p = 0.03). CONCLUSION: Initiation of pIONM supported by teleconsulting is feasible and requires a low workload.
Source: Techniques in Coloproctology
Authors: M. Paschold, E. Soufiah, L. Zimniak, F. Jäger, W. Kneist
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,390
OpenAlex ID: W4413137386