The grade determined by the remote physician was not communicated to the on-site physician, who was then asked to grade all the injuries at the end of the operative procedure. The two grades were compared to determine the accuracy of the remote physician in grading traumatic injuries MRT67307 cell line through the telepresence robot. Descriptive statistics selleck chemicals was used to analyze all survey results. Institutional Review Board The study was reviewed and approved by the University of Miami Institutional Review Board, the Jackson Memorial Hospital Clinical Research Review Committee and the Department of Defense

Human Research Protection Office. Results Data was collected on 50 surgical cases, both emergency (80%) and elective cases (20%). Patients were classified as trauma (70%) and non-trauma patients (30%). The majority of cases (64%) were emergency surgery on trauma patients, almost evenly distributed between penetrating (49%) and blunt trauma (51%). 40% of non-trauma cases were hernia-related Participants included 13 attending physicians and 9 fellows. There was a varied distribution of injuries and operative anatomical structures (Table 1) Table 1 Injury location distribution   # of cases   # of cases Trauma FK228 purchase Patients Non-Trauma Patients Head 1     Neck   Abdomen   Larynx 1 Wall 2     Inguinal Hernia

5 Chest   Ventral Hernia 2 Wall 4 Small bowel 3 Rib PAK5 1 Spleen 1 Vena Cava 1     Subclavian Artery/Vein 2 Inguinal Lymph Node 1 Abdomen   Unspecified 1 Wall 3     Stomach 1     Spleen 4     Bladder 1     Kidney 1     Small Bowel 4     Colon 5     Unspecified 2     Extremities 3     Miscellaneous       Skin graft

1     Remote physicians reported a high level of satisfaction with the use of the telepresence robot (Figure 3). Almost all remote participants (94%) agreed or strongly agreed being able to see the procedure well (Figure 4). The only times the remote clinician noted having difficulties visualizing the procedure occurred when the operating table was surrounded by a team of clinicians. Internet connectivity was an issue in 24% of the cases, ranging from minimal interruption to slow connection speeds. Crowding in the operating room obstructed the view for the remote physician in less than 20% of the cases; however, due to the slim design of the robot it could be moved to either the foot or head of the bed without interference. 94% of remote physicians and 74% of local physicians felt comfortable communicating via the telepresence system (Figures 5 and 6). To measure the value of the telepresence robot, we compared its use to that of the telephone. The most significant finding from the study is that all the local clinicians agreed that having access to a remote expert would be beneficial, and that to do so it would be more effective through telemedicine rather than just the telephone (Figures 7 and 8).