A safe teaching protocol of LRP (Laparoscopic Radical Prostatectomy)
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , |
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=S1677-55382018000200273 |
Resumo: | ABSTRACT Purpose The LRP has a steep learning curve to obtain proficiency during which patient safety may be compromised. We present an adapted modular training system which purpose to optimize the learning curve and perform a safe surgery. Materials and Methods A retrospective analysis of the LRP safe learning protocol applied during a fellowship program over eight years (2008-2015). The surgery was divided in 12 steps and 5 levels of difficulty. A maximum time interval was stipulated in 240 minutes. After an adaptation, the fellows had 120 minutes to perform all the corresponding modules to its accumulated skill. The participants gradually and safely pass through the steps and difficulty levels. Surgeries performed by fellows were analyzed as a single group and compared to a prior series performed by tutor. Results In eight years, 250 LRP were performed (25 per apprentice) during fellowship program and 150 procedures after completion. The baseline characteristics were comparable. Most cases operated were of intermediate risk. Mean operative time was longer in the fellow group when compared to the tutor (150 min). Mean estimated blood loss were similar among the groups. Functional and oncological outcomes were better in the Tutor's group. No conversion to open surgery was performed. Conclusions The LRP safe learning protocol proved to be an effective method to optimize the learning curve and perform safe surgery. However, the tutor's functional and oncological results were better, showing that this is a procedure with a steep learning curve and proficiency demands more than 25 cases. |
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International Braz J Urol (Online) |
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A safe teaching protocol of LRP (Laparoscopic Radical Prostatectomy)ProstatectomyEducationSurgical ProceduresOperativeABSTRACT Purpose The LRP has a steep learning curve to obtain proficiency during which patient safety may be compromised. We present an adapted modular training system which purpose to optimize the learning curve and perform a safe surgery. Materials and Methods A retrospective analysis of the LRP safe learning protocol applied during a fellowship program over eight years (2008-2015). The surgery was divided in 12 steps and 5 levels of difficulty. A maximum time interval was stipulated in 240 minutes. After an adaptation, the fellows had 120 minutes to perform all the corresponding modules to its accumulated skill. The participants gradually and safely pass through the steps and difficulty levels. Surgeries performed by fellows were analyzed as a single group and compared to a prior series performed by tutor. Results In eight years, 250 LRP were performed (25 per apprentice) during fellowship program and 150 procedures after completion. The baseline characteristics were comparable. Most cases operated were of intermediate risk. Mean operative time was longer in the fellow group when compared to the tutor (150 min). Mean estimated blood loss were similar among the groups. Functional and oncological outcomes were better in the Tutor's group. No conversion to open surgery was performed. Conclusions The LRP safe learning protocol proved to be an effective method to optimize the learning curve and perform safe surgery. However, the tutor's functional and oncological results were better, showing that this is a procedure with a steep learning curve and proficiency demands more than 25 cases.Sociedade Brasileira de Urologia2018-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382018000200273International braz j urol v.44 n.2 2018reponame:International Braz J Urol (Online)instname:Sociedade Brasileira de Urologia (SBU)instacron:SBU10.1590/s1677-5538.ibju.2017.0137info:eu-repo/semantics/openAccessTobias-Machado,MarcosPazeto,Cristiano LinckNeves-Neto,Oseas CastroNunes-Silva,IgorZampolli,Hamilton de Camposeng2018-04-17T00:00:00Zoai:scielo:S1677-55382018000200273Revistahttp://www.brazjurol.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||brazjurol@brazjurol.com.br1677-61191677-5538opendoar:2018-04-17T00:00International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)false |
dc.title.none.fl_str_mv |
A safe teaching protocol of LRP (Laparoscopic Radical Prostatectomy) |
title |
A safe teaching protocol of LRP (Laparoscopic Radical Prostatectomy) |
spellingShingle |
A safe teaching protocol of LRP (Laparoscopic Radical Prostatectomy) Tobias-Machado,Marcos Prostatectomy Education Surgical Procedures Operative |
title_short |
A safe teaching protocol of LRP (Laparoscopic Radical Prostatectomy) |
title_full |
A safe teaching protocol of LRP (Laparoscopic Radical Prostatectomy) |
title_fullStr |
A safe teaching protocol of LRP (Laparoscopic Radical Prostatectomy) |
title_full_unstemmed |
A safe teaching protocol of LRP (Laparoscopic Radical Prostatectomy) |
title_sort |
A safe teaching protocol of LRP (Laparoscopic Radical Prostatectomy) |
author |
Tobias-Machado,Marcos |
author_facet |
Tobias-Machado,Marcos Pazeto,Cristiano Linck Neves-Neto,Oseas Castro Nunes-Silva,Igor Zampolli,Hamilton de Campos |
author_role |
author |
author2 |
Pazeto,Cristiano Linck Neves-Neto,Oseas Castro Nunes-Silva,Igor Zampolli,Hamilton de Campos |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Tobias-Machado,Marcos Pazeto,Cristiano Linck Neves-Neto,Oseas Castro Nunes-Silva,Igor Zampolli,Hamilton de Campos |
dc.subject.por.fl_str_mv |
Prostatectomy Education Surgical Procedures Operative |
topic |
Prostatectomy Education Surgical Procedures Operative |
description |
ABSTRACT Purpose The LRP has a steep learning curve to obtain proficiency during which patient safety may be compromised. We present an adapted modular training system which purpose to optimize the learning curve and perform a safe surgery. Materials and Methods A retrospective analysis of the LRP safe learning protocol applied during a fellowship program over eight years (2008-2015). The surgery was divided in 12 steps and 5 levels of difficulty. A maximum time interval was stipulated in 240 minutes. After an adaptation, the fellows had 120 minutes to perform all the corresponding modules to its accumulated skill. The participants gradually and safely pass through the steps and difficulty levels. Surgeries performed by fellows were analyzed as a single group and compared to a prior series performed by tutor. Results In eight years, 250 LRP were performed (25 per apprentice) during fellowship program and 150 procedures after completion. The baseline characteristics were comparable. Most cases operated were of intermediate risk. Mean operative time was longer in the fellow group when compared to the tutor (150 min). Mean estimated blood loss were similar among the groups. Functional and oncological outcomes were better in the Tutor's group. No conversion to open surgery was performed. Conclusions The LRP safe learning protocol proved to be an effective method to optimize the learning curve and perform safe surgery. However, the tutor's functional and oncological results were better, showing that this is a procedure with a steep learning curve and proficiency demands more than 25 cases. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-04-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382018000200273 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382018000200273 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/s1677-5538.ibju.2017.0137 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
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.44 n.2 2018 reponame:International Braz J Urol (Online) instname:Sociedade Brasileira de Urologia (SBU) instacron:SBU |
instname_str |
Sociedade Brasileira de Urologia (SBU) |
instacron_str |
SBU |
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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1750318075925757952 |