A safe teaching protocol of LRP (Laparoscopic Radical Prostatectomy)

Detalhes bibliográficos
Autor(a) principal: Tobias-Machado,Marcos
Data de Publicação: 2018
Outros Autores: Pazeto,Cristiano Linck, Neves-Neto,Oseas Castro, Nunes-Silva,Igor, Zampolli,Hamilton de Campos
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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spelling 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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