Keyword: Telestration

ABSTRACT: Telemedicine has become a vital element of modern surgical practice, facilitating virtual consultations, intraoperative collaboration, and postoperative monitoring. One of its most innovative applications is remote proctoring, or teleproctoring—the real-time supervision and assistance of surgical procedures across distances. The COVID-19 epidemic has accelerated the impact of these technologies on surgical education, credentialing, and global access to specialized expertise. This narrative review synthesizes literature from 2005 to 2025 obtained from PubMed, ResearchGate, Web of Science, and Google Scholar. The emphasis includes telemedicine and remote proctoring in surgical care, education, and quality assurance. Chosen materials comprise original investigations, systematic reviews, and policy documents that pertain to technical platforms, clinical outcomes, educational applications, implementation issues, and regulatory considerations.  Modern teleproctoring technologies include secure, low-latency, high-definition video broadcasts enhanced by augmented reality features and telestration capabilities. The available evidence, primarily from observational studies, confirms the approach's viability, cost-effectiveness, improved training efficiency, and high user acceptance across disciplines such as minimally invasive, robotic, and endoscopic surgery. However, inconsistencies in outcome measurements, a lack of randomized controlled trials, and varying legal frameworks restrict wider applicability. The safety profiles appear promising, yet data deficiencies remain. Telemedicine and remote proctoring are developing into integral components of surgical care. Essential future directions include the implementation of artificial intelligence solutions, the development of standardized outcome metrics, the execution of comparative research, the enhancement of cybersecurity measures, and the promotion of fair access in resource-constrained settings. When integrated within strong regulatory and ethical frameworks, remote proctoring has the potential to function as a fundamental pillar of efficient and interconnected global surgical practice.