73 TELEMEDICINE AND e-HEALTH Volume 12, Number 1, 2006 © Mary Ann Liebert, Inc. Communication Telementoring in Endocrine Surgery: Preliminary Indian Experience P.V. PRADEEP, M.S., M.R.C.S.Ed., 1 S.K. MISHRA, M.S., 1,2 S. VAIDYANATHAN, M.B.B.S., M.S., 3 C. GOPALAKRISHNAN NAIR, M.B.B.S., M.S., 3 KRISHNAMOORTHY RAMALINGAM, M.S., 4 and RAJESH BASNET, M.C.A. 2 ABSTRACT Telemedicine is starting to play an important role in the health field in India. In this case re- port we describe the successful use of telementoring to remove a parathyroid tumor in a pa- tient with residual hyperparathyroidism after two previous unseccessful attempts in tumor excision. A 21-yr-old patient crippled with advanced hyperparathyroidism was taken up for third-time exploration at Amrita Institute of Medical Sciences (AIMS), Kochi, with guidance from the Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, using telemedicine technology. These two centers are located 2,500 km apart, and telemen- toring from the more experienced endocrine surgeons at SGPGIMS resulted in successful tumor localization and removal. For this session both the institutions were provided with a dedicated 512 Kbps very small aperture terminal (VSAT) link and two-way video-audio con- nectivity. Even though two previous explorations were unsuccessful, with the help of telemed- icine technology the same surgeon was successful in locating and removing the tumor. The video and audio quality was of good enough quality for the expert at SGPGIMS to guide the team at AIMS satisfactorily. The patient benefited since he did not have to travel to a far-off specialized center for surgery. This case report testifies to the usefulness of telemedicine in the field of surgery, especially in developing countries, which have few medical experts in certain specialized areas. 1 Department of Endocrine Surgery and 2 Telemedicine Center, Sanjay Gandhi Postgraduate Institute of Medical Sci- ences (SGPGIMS), Lucknow, Uttar Pradesh, India. 3 Department of General and Endocrine Surgery and 4 Telemedicine Department, Amrita Institute of Medical Sci- ences (AIMS), Kochi, Kerala, India. INTRODUCTION T ELEMENTORING is an advanced application of telemedicine that involves guidance or men- toring of a procedure in which the student/sur- geon, who has no or limited experience, is guided by a more experienced surgeon who is located at a distance from the patient and their surgeon. 1 Development of telemedicine in India is growing through a number of initiatives with support of the Indian Space Research organiza- tion (ISRO). 2 We discuss our successful tele- mentoring activities in a case of primary hyper- parathyroidism in which two previous attempts of tumor removal had failed. No such report has been published from India to date.