610 
J Marescaux
MD FRCS FACS
G Temporal
T Parent
R Bastier
D Mutter
MD PhD FACS
IRCAD-EITS Institute
1 Place de l’hôpital
BP 426
67091 Strasbourg Cedex
France
In a very short space of time, the internet has become an essential tool for people and companies, allowing them to keep in touch and exchange information no matter how far apart they are. All around the world, better access to the internet and the growth of broadband connections has allowed an ever-growing number of people easier access to high-quality media. The internet now provides a wide range of services, making it an essential tool for the easy access of information and media for everyone.
WeBSurg.com, the World Virtual University, created by IRCAD-EITS (University Louis Pasteur, Strasbourg, France), is similar to an electronic journal, including: chapters describing key minimally invasive surgical procedures; monthly publications of videos of surgical procedures performed by a network of internationally renowned experts and expert advice on cutting edge surgical techniques. Using the latest multimedia technologies, the Virtual University provides both an overview and precise descriptions of over 130 procedures in minimal access surgery (see Figure 1), 570 videos of surgical interventions (see Figure 2), over 90 mini-conferences (see Figure 3) and over 1,000 expert interviews and debates (see Figure 4). Videos of surgical interventions and mini-conferences are organised in sequence to allow easy navigation from one important step to the next. Advice from expert surgeons is delivered through interviews and lectures, bridging the gap between theoretical teaching and real-time practice.
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As such, WeBSurg.com represents a remarkable model of surgical education and internet-based simulation. It integrates multimedia e-learning and e-training models, using the latest technologies to display videos, texts and illustrations simultaneously. Because WeBSurg.com membership is free and unlimited, it can provide to its numerous members high-quality educational videos in different formats, namely QuickTime, Windows Media Player and Real Player, regardless of where they live or their means. Indeed, the growth of foreign connections has led to the translation of its contents from English and French in 2001 to Spanish, Japanese, and traditional and simplified Chinese in 2007. The origin of the connections on WeBSurg are therefore varied: Europe (37%), North America (25%), Asia (19%), South America (12%), Africa (6%) and Oceania (1%) (see Figure 5).
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The success of the website is also due to its relevant and up-to-date contents. WeBSurg.com respects the principles and guidelines set out for health-related websites. Approval of content suitability from organisations such as the Swiss Health on the Net Foundation (HON Code) is testimony to the overall goals of the website: promoting science and the art of surgery to improve public health, updating surgeons on new technologies and providing continuing medical education to support informed clinical decisions, and promoting integrity in science and surgery.
The accreditation of 42 of its educational chapters allows the members to obtain CME (Continuing Medical Education) credits, thus providing a university-backed validation of the learning process (thanks to a partnership with Canada’s McMaster University). The credits are issued by the American Medical Association (AMA category 1 credits™) and by the Royal College of Physicians and Surgeons of Canada. Each educational session incorporates text-based chapters on the surgical interventions for specific diseases with still images, videos and other multimedia tools to provide an interactive, self-paced learning environment for physicians and other healthcare professionals. These new learning methods are increasingly being used, from 254 CME credits obtained in 2002 to 4038 by the end of October 2007, and are steadily growing every year (see Figure 6).
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WeBSurg.com also presents the newest technologies and a lot of educational material on a wide range of surgical fields: general and digestive surgery, endocrine surgery, pediatric surgery, gynaecological surgery, urology, thoracic surgery, interventional GI endoscopy and cardiovascular surgery.
Pioneering work such as NOTES (Natural Orifice Transluminal Endoscopic Surgery) and robotic-assisted surgery is also covered, providing a regular update to its members on the latest developments and breakthroughs in these fields. Despite the subscription-free World Virtual University relying on industrial sponsorship, the scientific editorial staff of WeBSurg.com are totally independent, so it provides unbiased content to its members in all the surgical fields it describes.
Keeping pace with rapidly changing technologies is also very important for a website specialising in media transmission. Recent technology has made it possible to display items of WeBSurg.com on handheld devices (personal data/digital assistance, also known as PDAs, Pocket PCs and smart phones).
All these factors have made WeBSurg.com a popular and influential resource and have led to a 2,700% increase in the hits on videos, from 16,000 in January 2004 to 243,000 in October 2007. There are 97,000 monthly visits, with 805,000 pages viewed in October 2007 alone. To date, a total of 60,000 healthcare professionals have been regular members of WeBSurg.com, whereas only 8,570 surgeons were registered in January 2004, a 540% increase (see Figure 7). WeBSurg.com keeps its members informed via a monthly newsletter sent to over 77,600 valid email addresses, with 3,500 new registrations every month (see Figure 8).
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The internet and new communications technologies contribute to the worldwide diffusion of scientific information in an easy and user-friendly way. It heralds the advent of a new technological era serving educational telementoring purposes and scientific surgical needs.
WeBSurg.com fulfils the ideal of providing the best in tutorials, in knowledge transmission and in know-how in a short period of time on a worldwide scale. Considering that paper journals may be slow in editing information, the internet eases and accelerates the process of “spreading the news”, which is a determining asset in the field of new surgical technologies.
