Robotic-assisted radical prostatectomy learning curve for experienced laparoscopic surgeons: does it really exist?

Detalhes bibliográficos
Autor(a) principal: Tobias-Machado,Marcos
Data de Publicação: 2016
Outros Autores: Mitre,Anuar Ibrahim, Rubinstein,Mauricio, Costa,Eduardo Fernandes da, Hidaka,Alexandre Kyoshi
Tipo de documento: Artigo
Idioma: eng
Título da fonte: International Braz J Urol (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000100083
Resumo: ABSTRACT Background Robotic-assisted radical prostatectomy (RALP) is a minimally invasive procedure that could have a reduced learning curve for unfamiliar laparoscopic surgeon. However, there are no consensuses regarding the impact of previous laparoscopic experience on the learning curve of RALP. We report on a functional and perioperative outcome comparison between our initial 60 cases of RALP and last 60 cases of laparoscopic radical prostatectomy (LRP), performed by three experienced laparoscopic surgeons with a 200+LRP cases experience. Materials and Methods Between January 2010 and September 2013, a total of 60 consecutive patients who have undergone RALP were prospectively evaluated and compared to the last 60 cases of LRP. Data included demographic data, operative duration, blood loss, transfusion rate, positive surgical margins, hospital stay, complications and potency and continence rates. Results The mean operative time and blood loss were higher in RALP (236 versus 153 minutes, p<0.001 and 245.6 versus 202ml p<0.001). Potency rates at 6 months were higher in RALP (70% versus 50% p=0.02). Positive surgical margins were also higher in RALP (31.6% versus 12.5%, p=0.01). Continence rates at 6 months were similar (93.3% versus 89.3% p=0.43). Patient’s age, complication rates and length of hospital stay were similar for both groups. Conclusions Experienced laparoscopic surgeons (ELS) present a learning curve for RALP only demonstrated by longer operative time and clinically insignificant blood loss. Our initial results demonstrated similar perioperative and functional outcomes for both approaches. ELS were able to achieve satisfactory oncological and functional results during the learning curve period for RALP.
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spelling Robotic-assisted radical prostatectomy learning curve for experienced laparoscopic surgeons: does it really exist?LaparoscopyProstatectomyProstatic NeoplasmsRobotic Surgical ProceduresABSTRACT Background Robotic-assisted radical prostatectomy (RALP) is a minimally invasive procedure that could have a reduced learning curve for unfamiliar laparoscopic surgeon. However, there are no consensuses regarding the impact of previous laparoscopic experience on the learning curve of RALP. We report on a functional and perioperative outcome comparison between our initial 60 cases of RALP and last 60 cases of laparoscopic radical prostatectomy (LRP), performed by three experienced laparoscopic surgeons with a 200+LRP cases experience. Materials and Methods Between January 2010 and September 2013, a total of 60 consecutive patients who have undergone RALP were prospectively evaluated and compared to the last 60 cases of LRP. Data included demographic data, operative duration, blood loss, transfusion rate, positive surgical margins, hospital stay, complications and potency and continence rates. Results The mean operative time and blood loss were higher in RALP (236 versus 153 minutes, p<0.001 and 245.6 versus 202ml p<0.001). Potency rates at 6 months were higher in RALP (70% versus 50% p=0.02). Positive surgical margins were also higher in RALP (31.6% versus 12.5%, p=0.01). Continence rates at 6 months were similar (93.3% versus 89.3% p=0.43). Patient’s age, complication rates and length of hospital stay were similar for both groups. Conclusions Experienced laparoscopic surgeons (ELS) present a learning curve for RALP only demonstrated by longer operative time and clinically insignificant blood loss. Our initial results demonstrated similar perioperative and functional outcomes for both approaches. ELS were able to achieve satisfactory oncological and functional results during the learning curve period for RALP.Sociedade Brasileira de Urologia2016-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000100083International braz j urol v.42 n.1 2016reponame:International Braz J Urol (Online)instname:Sociedade Brasileira de Urologia (SBU)instacron:SBU10.1590/S1677-5538.IBJU.2014.0485info:eu-repo/semantics/openAccessTobias-Machado,MarcosMitre,Anuar IbrahimRubinstein,MauricioCosta,Eduardo Fernandes daHidaka,Alexandre Kyoshieng2016-03-28T00:00:00Zoai:scielo:S1677-55382016000100083Revistahttp://www.brazjurol.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||brazjurol@brazjurol.com.br1677-61191677-5538opendoar:2016-03-28T00:00International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)false
dc.title.none.fl_str_mv Robotic-assisted radical prostatectomy learning curve for experienced laparoscopic surgeons: does it really exist?
title Robotic-assisted radical prostatectomy learning curve for experienced laparoscopic surgeons: does it really exist?
spellingShingle Robotic-assisted radical prostatectomy learning curve for experienced laparoscopic surgeons: does it really exist?
Tobias-Machado,Marcos
Laparoscopy
Prostatectomy
Prostatic Neoplasms
Robotic Surgical Procedures
title_short Robotic-assisted radical prostatectomy learning curve for experienced laparoscopic surgeons: does it really exist?
title_full Robotic-assisted radical prostatectomy learning curve for experienced laparoscopic surgeons: does it really exist?
title_fullStr Robotic-assisted radical prostatectomy learning curve for experienced laparoscopic surgeons: does it really exist?
title_full_unstemmed Robotic-assisted radical prostatectomy learning curve for experienced laparoscopic surgeons: does it really exist?
title_sort Robotic-assisted radical prostatectomy learning curve for experienced laparoscopic surgeons: does it really exist?
author Tobias-Machado,Marcos
author_facet Tobias-Machado,Marcos
Mitre,Anuar Ibrahim
Rubinstein,Mauricio
Costa,Eduardo Fernandes da
Hidaka,Alexandre Kyoshi
author_role author
author2 Mitre,Anuar Ibrahim
Rubinstein,Mauricio
Costa,Eduardo Fernandes da
Hidaka,Alexandre Kyoshi
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Tobias-Machado,Marcos
Mitre,Anuar Ibrahim
Rubinstein,Mauricio
Costa,Eduardo Fernandes da
Hidaka,Alexandre Kyoshi
dc.subject.por.fl_str_mv Laparoscopy
Prostatectomy
Prostatic Neoplasms
Robotic Surgical Procedures
topic Laparoscopy
Prostatectomy
Prostatic Neoplasms
Robotic Surgical Procedures
description ABSTRACT Background Robotic-assisted radical prostatectomy (RALP) is a minimally invasive procedure that could have a reduced learning curve for unfamiliar laparoscopic surgeon. However, there are no consensuses regarding the impact of previous laparoscopic experience on the learning curve of RALP. We report on a functional and perioperative outcome comparison between our initial 60 cases of RALP and last 60 cases of laparoscopic radical prostatectomy (LRP), performed by three experienced laparoscopic surgeons with a 200+LRP cases experience. Materials and Methods Between January 2010 and September 2013, a total of 60 consecutive patients who have undergone RALP were prospectively evaluated and compared to the last 60 cases of LRP. Data included demographic data, operative duration, blood loss, transfusion rate, positive surgical margins, hospital stay, complications and potency and continence rates. Results The mean operative time and blood loss were higher in RALP (236 versus 153 minutes, p<0.001 and 245.6 versus 202ml p<0.001). Potency rates at 6 months were higher in RALP (70% versus 50% p=0.02). Positive surgical margins were also higher in RALP (31.6% versus 12.5%, p=0.01). Continence rates at 6 months were similar (93.3% versus 89.3% p=0.43). Patient’s age, complication rates and length of hospital stay were similar for both groups. Conclusions Experienced laparoscopic surgeons (ELS) present a learning curve for RALP only demonstrated by longer operative time and clinically insignificant blood loss. Our initial results demonstrated similar perioperative and functional outcomes for both approaches. ELS were able to achieve satisfactory oncological and functional results during the learning curve period for RALP.
publishDate 2016
dc.date.none.fl_str_mv 2016-02-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S1677-5538.IBJU.2014.0485
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Urologia
publisher.none.fl_str_mv Sociedade Brasileira de Urologia
dc.source.none.fl_str_mv International braz j urol v.42 n.1 2016
reponame:International Braz J Urol (Online)
instname:Sociedade Brasileira de Urologia (SBU)
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institution SBU
reponame_str International Braz J Urol (Online)
collection International Braz J Urol (Online)
repository.name.fl_str_mv International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)
repository.mail.fl_str_mv ||brazjurol@brazjurol.com.br
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