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laparoscopic hernia repair in children. He recently began offering a relatively new treatment for drug refractory gastropare- sis using a gastric electrical stimulation (GES) device. Similar to a pacemaker, the device is implanted laparoscopically above the abdominal muscle under the skin to stimulate the stomach. "While GED resolves symptoms in the majority of patients, it is not effective in about 30 percent of patients. To predict who will respond favorably, I perform a temporary stim," he says. During this outpatient procedure, probes are placed endoscopically in the stomach. These probes are then attached to a stimulator device the patient wears around the neck or on the abdomen, which mimics the operation of the GES device. "If the temporary stim offers relief, it's a good indication the patient will benefit from a permanent one," says Dr. Ponsky. World Outreach As one of only a few surgeons implant- ing these devices in children, Dr. Ponsky is training other surgeons and gastro- enterologists to perform the temporary and permanent stim procedures through telementoring. Still in its infancy, tele- mentoring is based on the one-on-one mentor-mentee relationship used in teaching hospitals around the world. As the mentor, Dr. Ponsky takes part in the surgery through a computer con- nected to a mobile monitor in the mentee surgeon's OR. Dr. Ponsky can observe the surgery from above or laparoscopically, talk to the mentee in real time, offer instructions with a laser pointer, and sketch ideas on the monitor to explain technical points that may arise. "While technology is a key component of telementoring, it's just a tool," says Dr. Ponsky. "The mentee surgeon must have a basis of knowledge and experience with the procedure being learned. Additionally, the dialogue between the surgeons before beginning the procedure supports a successful outcome." Dr. Ponsky's idea for telementoring evolved from a tele-education program, called GlobalCast MD, he developed several years ago. It broadcasts medi- cal education programs via interactive TV streamed over the Internet from a studio at Akron Children's. Participants can call in, text, or chat their questions and comments to program leaders and each other. "We inv ite exper ts from a round the world, and many are from Akron Children's, to discuss and demonstrate techniques in our studio. The audience can interact with the panel of experts in real time," he says. "So it's really a live chat room where doctors can learn about current concepts in medicine." Launched in 2010, the response to PHOTO COURTESY OF AKRON CHILDREN'S HOSPITAL Oliver Soldes, MD, provides outpatient surgery services in the Mahoning Valley at Akron Children's Beeghly Campus twice a week. The other five pediatric surgeons do the same at MetroHealth Medical Center in Cleveland, where they also provide 24/7 emergency and inpatient coverage per an agreement between the two hospitals. SPECI A L FE AT UR E 1 4 | Cleveland/Akron/Canton MD NEWS ■ M D N E W S . CO M ■ M AY/J U N E 2 0 1 4