World’s first remote anaesthesia across continents
10 Sept 2010
A world first was achieved by McGill University’s Department
of Anesthesia on August 30, 2010, when they treated patients undergoing
thyroid gland surgery in Italy remotely from Montreal, Canada.
This achievement was the result of a collaboration between McGill
University and the Department of Anaesthesia of Pisa
The approach is part of new technological advancements, known as teleanaesthesia, which involves a team of engineers, researchers and
anaesthesiologists who will ultimately apply the drugs intravenously
which are then controlled remotely through an automated system.
“The practice has obvious applications in countries with a
significant number of people living in remote areas, like Canada,
where specialists may not be available on site,” said McGill
University team leader Dr Thomas Hemmerling. “It could also be used
for teaching purposes, allowing the resident to perform tasks
without the physical presence of a tutor, thus increasing his or her
Four strategically placed video cameras monitored every aspect of
patient care in Pisa, Italy, in real time. Ventilation parameters
(such as the patient’s breathing rate), vital signs (ECG, heart
rate, oxygen saturation) and live images of the surgery are
monitored by each camera, with the fourth used for special purposes.
A remote computer station (called the ‘anaesthesia cockpit’) is
required, as is a workstation that handles the audio-video link
between the two centres. “Obviously, local anaesthesiologists can
override the process at any time,” Hemmerling explained. Prior to
the operation, an assessment of the patient’s airway and medical
history is also performed via videoconferencing.
The researchers are also looking at the possibility of
preoperative assessment of patients at home. It used to be that
invasive blood tests or other tests were required in preparation for
many surgeries, but that’s no longer the case.
Many patients take very long journeys and often wait hours to see
an anaesthesiologist who will ask them specific questions, but
videoconferencing could eliminate these logistical problems and
probably reduce the preoperative stress of the patients coming into
the hospital before surgery. “The next steps will be to confirm the
results of this pilot experience with further studies,” Hemmerling
Photos of the cross-continental teleanaesthesia
Anaesthesia cockpit in Montreal controlling
anaesthesia in Pisa. Credit: Dept. of Anaesthesia, McGill
Video-real stream in Montreal from patient
monitoring in Pisa. Credit: Dept. of Anaesthesia, McGill
Preoperative remote patient assessment.
Credit: Dept. of Anaesthesia, McGill University, Montreal
Live stream from surgical site taken from
computer screen. Credit: Dept. of Anesthesia, McGill University,
Video of Dr Hemmerling explaining an automated
For more information on new anaesthesia technology being
developed at McGill University see: