Telemedicine versus face‐to‐face follow up in general surgery: a randomized controlled trial

BACKGROUND: Telemedicine provides healthcare to patients at a distance from their treating clinician. There is a lack of high‐quality evidence to support the safety and acceptability of telemedicine for postoperative outpatient follow‐up. This randomized controlled trial—conducted before the COVID‐19 pandemic—aimed to assess patient satisfaction and safety (as determined by readmission, reoperation and complication rates) by telephone compared to face‐to‐face follow‐up after uncomplicated general surgical procedures. METHODS: Patients following laparoscopic appendicectomy or cholecystectomy and laparoscopic or open umbilical or inguinal hernia repairs were randomized to a telephone or face‐to‐face outpatient clinic. Patient demographics, perioperative details and postoperative outcomes were compared. Patient satisfaction was assessed via a standardized Likert‐style scale. RESULTS: One hundred and twenty‐three patients were randomized over 12 months. Mean consultation times were significantly shorter for telemedicine than face‐to‐face clinics (telemedicine 10.52 ± 7.2 min, face‐to‐face 15.95 ± 9.96 min, P = 0.0021). There was no difference between groups in the attendance rates, nor the incidence or detection of postoperative complications. Of the 58 patients randomized to the telemedicine arm, 40% reported high, and 60% reported very high satisfaction with the method of clinic follow‐up. CONCLUSION: Telemedicine postoperative follow‐up is safe and acceptable to patients and could be considered in patients undergoing uncomplicated benign general surgery.