Telephotography in general robotic surgery: initial experience in inguinal herniorrhaphy in Colombia

Abstract

Introduction: Teleproctography has emerged as an innovative alternative to facilitate remote surgical mentoring in minimally invasive and robotic surgery, overcoming geographical and economic barriers and thus increasing accessibility to these surgical techniques. We present the first reported clinical experience in Colombia on the use of this modality during a robot-assisted laparoscopic inguinal hernia repair. Materials and Methods: We report the case of a 66-year-old male patient with a history of robot-assisted radical prostatectomy with lymphadenectomy, scheduled for a robot-assisted inguinal herniorrhaphy using the TAPP approach. The procedure was supervised via the Rodes & Cones platform, with the proctor located 1,000 km away. Clinical variables and the technical feasibility of teleproctography were recorded. Results: The total operative time was 3 hours, with an estimated blood loss of 20 cc, no intraoperative complications, and no need for conversion to open surgery. The patient was discharged 24 hours later, with an uneventful recovery. Teleproctorship enabled continuous and effective communication, with uninterrupted real-time audio and video transmission, facilitating guidance throughout the procedure. Conclusions: This report demonstrates that teleproctorship in robotic surgery is feasible, safe, and effective, even in complex cases. Its implementation can become a key tool for expanding access to highly complex procedures in Colombia, especially in centers that do not have an on-site proctor.