Analysis of the Learning Curve of Surgeons without Previous Experience in Laparoscopy to Perform Robot-Assisted Radical Prostatectomy

Objective. To assess the learning curve in robot-assisted radical prostatectomy (RARP) performed by surgeons without previous experience in laparoscopic prostatectomy. Materials and Methods. We analyzed 119 patients submitted to RARP performed by two surgeons without previous experience in laparosco...

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Main Authors: Felipe Monnerat Lott, Deborah Siqueira, Hermano Argolo, Bernardo Lindberg Nóbrega, Franz Santos Campos, Luciano Alves Favorito
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Advances in Urology
Online Access:http://dx.doi.org/10.1155/2018/9073807
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author Felipe Monnerat Lott
Deborah Siqueira
Hermano Argolo
Bernardo Lindberg Nóbrega
Franz Santos Campos
Luciano Alves Favorito
author_facet Felipe Monnerat Lott
Deborah Siqueira
Hermano Argolo
Bernardo Lindberg Nóbrega
Franz Santos Campos
Luciano Alves Favorito
author_sort Felipe Monnerat Lott
collection DOAJ
description Objective. To assess the learning curve in robot-assisted radical prostatectomy (RARP) performed by surgeons without previous experience in laparoscopic prostatectomy. Materials and Methods. We analyzed 119 patients submitted to RARP performed by two surgeons without previous experience in laparoscopic prostatectomy, with emphasis on the relevant outcomes such as continence, erectile function, and oncologic control with a minimum follow-up of 24 months. We used Fisher’s exact test and the chi-square test to investigate the existence of a relationship between the variables and analysis of variance (ANOVA) to verify possible statistically significant differences between groups, at the 5% level. Results. The patients’ age varied from 41 to 72 years (mean = 61.09), with 68 (57.14%) cases having intermediate or high risk. There was a consistent decline in operative time. Of the 119 patients, 80.67% were continent 6 months after surgery and 89.07% 12 months afterward, while 35.29% were potent 6 months after surgery and 60.50% 12 months following surgery. Twelve months after surgery, the trifecta outcome rate was 51.26% and the pentafecta rate was 31.09%. There was progressive postoperative improvement and maintenance of continence and sexual potency until the last patient was operated in our sample. Conclusions. Robot-assisted radical prostatectomy does not require previous experience in laparoscopic radical prostatectomy, but the learning curve is not short to achieve the plateau.
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spelling doaj-art-acfeec0212014cc29b90e86f06de6d252025-02-03T05:46:26ZengWileyAdvances in Urology1687-63691687-63772018-01-01201810.1155/2018/90738079073807Analysis of the Learning Curve of Surgeons without Previous Experience in Laparoscopy to Perform Robot-Assisted Radical ProstatectomyFelipe Monnerat Lott0Deborah Siqueira1Hermano Argolo2Bernardo Lindberg Nóbrega3Franz Santos Campos4Luciano Alves Favorito5Brazilian National Cancer Institute, Rio de Janeiro, BrazilBrazilian National Cancer Institute, Rio de Janeiro, BrazilBrazilian National Cancer Institute, Rio de Janeiro, BrazilBrazilian National Cancer Institute, Rio de Janeiro, BrazilBrazilian National Cancer Institute, Rio de Janeiro, BrazilUrogenital Research Unit, State University of Rio de Janeiro (UERJ), Rio de Janeiro-RJ, BrazilObjective. To assess the learning curve in robot-assisted radical prostatectomy (RARP) performed by surgeons without previous experience in laparoscopic prostatectomy. Materials and Methods. We analyzed 119 patients submitted to RARP performed by two surgeons without previous experience in laparoscopic prostatectomy, with emphasis on the relevant outcomes such as continence, erectile function, and oncologic control with a minimum follow-up of 24 months. We used Fisher’s exact test and the chi-square test to investigate the existence of a relationship between the variables and analysis of variance (ANOVA) to verify possible statistically significant differences between groups, at the 5% level. Results. The patients’ age varied from 41 to 72 years (mean = 61.09), with 68 (57.14%) cases having intermediate or high risk. There was a consistent decline in operative time. Of the 119 patients, 80.67% were continent 6 months after surgery and 89.07% 12 months afterward, while 35.29% were potent 6 months after surgery and 60.50% 12 months following surgery. Twelve months after surgery, the trifecta outcome rate was 51.26% and the pentafecta rate was 31.09%. There was progressive postoperative improvement and maintenance of continence and sexual potency until the last patient was operated in our sample. Conclusions. Robot-assisted radical prostatectomy does not require previous experience in laparoscopic radical prostatectomy, but the learning curve is not short to achieve the plateau.http://dx.doi.org/10.1155/2018/9073807
spellingShingle Felipe Monnerat Lott
Deborah Siqueira
Hermano Argolo
Bernardo Lindberg Nóbrega
Franz Santos Campos
Luciano Alves Favorito
Analysis of the Learning Curve of Surgeons without Previous Experience in Laparoscopy to Perform Robot-Assisted Radical Prostatectomy
Advances in Urology
title Analysis of the Learning Curve of Surgeons without Previous Experience in Laparoscopy to Perform Robot-Assisted Radical Prostatectomy
title_full Analysis of the Learning Curve of Surgeons without Previous Experience in Laparoscopy to Perform Robot-Assisted Radical Prostatectomy
title_fullStr Analysis of the Learning Curve of Surgeons without Previous Experience in Laparoscopy to Perform Robot-Assisted Radical Prostatectomy
title_full_unstemmed Analysis of the Learning Curve of Surgeons without Previous Experience in Laparoscopy to Perform Robot-Assisted Radical Prostatectomy
title_short Analysis of the Learning Curve of Surgeons without Previous Experience in Laparoscopy to Perform Robot-Assisted Radical Prostatectomy
title_sort analysis of the learning curve of surgeons without previous experience in laparoscopy to perform robot assisted radical prostatectomy
url http://dx.doi.org/10.1155/2018/9073807
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