Learning robotic pyeloplasty without simulators: an assessment of the learning curve in the early robotic era

• Autor(a) principal: Chammas Jr, Mario F.
• Data de Publicação: 2019
• Outros Autores: Mitre, Anuar I., Arap, Marco A., Hubert, Nicholas, Hubert, Jacques
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Clinics
• Texto Completo: https://www.revistas.usp.br/clinics/article/view/159499
• topic: Robotic-Assisted; Laparoscopy; Ureteropelvic Junction Obstruction; Education; Learning Curve

OBJECTIVE: To analyze our experience and learning curve for robotic pyeloplasty during this robotic procedure. METHODS: Ninety-nine patients underwent 100 consecutive procedures. Cases were divided into 4 groups of 25 consecutive procedures to analyze the learning curve. RESULTS: The median anastomosis times were 50.0, 36.8, 34.2 and 29.0 minutes (p=0.137) in the sequential groups, respectively. The median operative times were 144.6, 119.2, 114.5 and 94.6 minutes, with a significant difference between groups 1 and 2 (p=0.015), 1 and 3 (p=0.002), 1 and 4 (po0.001) and 2 and 4 (p=0.022). The mean hospital stay was 7.08, 4.76, 4.88 and 4.20 days, with a difference between groups 1 and 2 (po0.001), 1 and 3 (po0.001) and 1 and 4 (po0.001). Clinical and radiological improvements were observed in 98.9% of patients. One patient presented with recurrent obstruction. CONCLUSIONS: Our results demonstrate a high success rate with low complication rates. A significant decrease in hospital stay and surgical time was evident after 25 cases.