Telemedicine facilitates surgical training in placenta accreta spectrum

Objective The training of groups responsible for managing patients with placenta accreta spectrum (PAS) is complex because of the lack of hospitals with a high flow of patients and absence of formal educational programs. We report the results of a virtual training program (VTP) that implement one-step conservative surgery (OSCS). Methods A prospective observation study of OSCS VTP between three expert groups and PAS reference hospitals without experience in OSCS was performed. Accessible or cost-efficient web meeting platforms were used to implement the VTP components: baseline observation of the participant's prior knowledge; instructions about essential PAS surgery topics; base selection and joint planning of surgery; expert group "telepresence" during surgery and postoperative debriefing. Results OSCS was performed successfully at 6 hospitals. All patients had increta/percreta with a median intraoperative bleeding of 1300 mL (IQR 825-2325) and surgical time of 184 minutes (IQR 113-240). All groups considered the VTP very useful (n=33, 97%) or useful (n=1, 3%), they would use it again (definitely: n=27, 81.8%; or probably: n=6, 18.2%), and they would recommend it to other colleagues. Conclusion Tele education and telepresence during PAS surgery facilitates the implementation of OSCS in selected cases.