2023 THE SURGICAL LEARNING CURVE FOR ROBOTIC PROSTATECTOMY: A MULTI-INSTITUTIONAL STUDY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized X1 Apr 20102023 THE SURGICAL LEARNING CURVE FOR ROBOTIC PROSTATECTOMY: A MULTI-INSTITUTIONAL STUDY David Peters, David Lee, Peter Wiklund, Jason Fung, Majnu John, Abhishek Srivastava, Kumaran Mudaliar, Sonal Grover, Youssef El Douaihy, Robert Leung, and Ashutosh Tewari David PetersDavid Peters New York, NY More articles by this author , David LeeDavid Lee Philadelphia, PA More articles by this author , Peter WiklundPeter Wiklund Solna, Sweden More articles by this author , Jason FungJason Fung New York, NY More articles by this author , Majnu JohnMajnu John New York, NY More articles by this author , Abhishek SrivastavaAbhishek Srivastava New York, NY More articles by this author , Kumaran MudaliarKumaran Mudaliar New York, NY More articles by this author , Sonal GroverSonal Grover New York, NY More articles by this author , Youssef El DouaihyYoussef El Douaihy New York, NY More articles by this author , Robert LeungRobert Leung New York, NY More articles by this author , and Ashutosh TewariAshutosh Tewari New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2069AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES As surgical procedures have increased in complexity, the surgical learning curve has become a fundamental tool for establishing the experience level required for a surgeon to achieve optimum surgical outcomes. Our aim is to characterize the learning curve for robot-assisted radical prostatectomy (RARP) by examining surgical efficacy in terms of positive surgical margin (PSM) rates and operative time (ORT). METHODS We performed a retrospective cohort study of patients from three individual robotic surgeons from different centers. From January 2003 to September 2009, a total of of 3794 patients underwent RARP for treatment of prostate cancer across all three centers. In order to produce a learning curve, mean overall PSM rates and mean overall ORT were calculated for all three surgeons at intervals of 50 RARPs per surgeon. Learning curves for these means were fit using a Loess method. R version 2.71. was used for all statistical analysis. RESULTS Preoperative clinicopathologic characteristics of age, body mass index (BMI), prostate volume, pre-operative PSA, biopsy Gleason sum, and clinical stage were comparable between patients at all three centers. Figure 1 represents the learning curve based on percentage positive surgical margins, with an improvement in overall PSM rates beginning at approximately 800 robotic procedures. The PSM rate across the all 3 cohorts improved to less than 10% by approximately 1600 cases. Mean surgical operative time plateaued at approximately 750 cases (Figure 2). CONCLUSIONS Increasing surgical experience appears to be associated with a reduced percentage of positive surgical margins and operative time after robot-assisted radical prostatectomy. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e784-e785 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Peters New York, NY More articles by this author David Lee Philadelphia, PA More articles by this author Peter Wiklund Solna, Sweden More articles by this author Jason Fung New York, NY More articles by this author Majnu John New York, NY More articles by this author Abhishek Srivastava New York, NY More articles by this author Kumaran Mudaliar New York, NY More articles by this author Sonal Grover New York, NY More articles by this author Youssef El Douaihy New York, NY More articles by this author Robert Leung New York, NY More articles by this author Ashutosh Tewari New York, NY More articles by this author Expand All Advertisement Advertisement PDF DownloadLoad