1
|
Çelen S, Özlülerden Y, Mete A, Başer A, Tuncay ÖL, Zümrütbaş AE. Laparoscopic radical prostatectomy: a single surgeon’s experience in 80 cases after 2 years of formal training. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00159-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To assess the learning curve in laparoscopic radical prostatectomy (LRP) performed by a single surgeon who had a healthcare career as a surgical first assistant for 2 years in high-volume centers treating > 150 cases per year.
Methods
The records of 80 LRP cases performed between October 2017 and August 2018 by a single surgeon were consecutively divided into four groups (groups A = first 20 cases, B = second 20 cases, C = third 20 cases, and D = last 20 cases). The groups were compared in terms of surgical and functional outcomes with a minimum follow-up of 6 months.
Results
Clinical and surgical stages of the four groups were similar between groups. The operative time (126.8 ± 5.48 min; P = 0.001) and time of removal of the drain (1.65 ± 0.93 days; P = 0.029) were significantly lower in group D; however, hospitalization, catheterization time, and blood loss were similar between groups. The complication rate was low. No patient had a visceral injury, and there were no procedures needed to open conversion. The positive surgical margin (PSM) rates were similar between groups. In terms of continence and potency, all groups were similar at the 6th-month follow-up after surgery.
Conclusions
Our results showed that prior experience in laparoscopic surgery as a surgical first assistant in a high-volume center improves the learning curve and oncological and functional outcomes, and helps to minimize the complication rate
Collapse
|
2
|
Haxhimolla H, Maré A. Establishing a teaching unit in laparoscopic radical prostatectomy: An Australian experience. JOURNAL OF CLINICAL UROLOGY 2017. [DOI: 10.1177/2051415816671466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The aim of this project was to examine the role of surgical mentorship on the perioperative and oncological outcomes of patients undergoing laparoscopic radical prostatectomy (LRP) performed by two urologists inexperienced in the procedure. Methods: Forty-one (41) consecutive LRP cases were performed for clinically localised prostate cancer between December 2006 and June 2008 at a single centre. The surgical mentor approach was used with an experienced LRP surgeon being present for all cases that were performed by two urologists training in LRP. Data was retrospectively reviewed to assess morbidity and oncological outcomes of patients undergoing LRP by the team of trainees. Results: No LRP cases were converted to open and no major intraoperative complications were noted. Mean intraoperative blood loss was 493 ml (range 150–1000 ml) with the mean operative time being 220 minutes (range 100–315 minutes). The overall positive margin rate was only 12% (five out of 41 cases). Conclusion: LRP teaching units can be established with appropriate mentor supervision and can result in good oncological outcomes and minimal morbidity that compares favourably to robotic-assisted radical prostatectomy (RARP).
Collapse
Affiliation(s)
- H Haxhimolla
- Department of Urology, The Canberra Hospital, Australia
- National Capital Private Hospital, Australia
- Australian National University, Australia
| | - A Maré
- Department of Urology, The Canberra Hospital, Australia
| |
Collapse
|
3
|
Louie-Johnsun MW, Handmer MM, Calopedos RJS, Chabert C, Cohen RJ, Gianduzzo TRJ, Kearns PA, Moon DA, Ooi J, Shannon T, Sofield D, Tan AHH. The Australian laparoscopic non robotic radical prostatectomy experience - analysis of 2943 cases (USANZ supplement). BJU Int 2016; 118 Suppl 3:43-48. [DOI: 10.1111/bju.13610] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Mark William Louie-Johnsun
- Department of Urology; Gosford, Wyong and Gosford Private Hospitals and University of Newcastle; Gosford NSW Australia
| | - Marcus M. Handmer
- Department of Urology; Gosford, Wyong and Gosford Private Hospitals and University of Newcastle; Gosford NSW Australia
| | - Ross John Spero Calopedos
- Department of Urology; Gosford, Wyong and Gosford Private Hospitals and University of Newcastle; Gosford NSW Australia
| | - Charles Chabert
- Department of Urology; Pindara Private Hospital; Benowa Qld Australia
| | - Ronald J. Cohen
- Department of Pathology; Uropath and University of Western Australia; Perth WA Australia
| | | | - Paul A. Kearns
- Department of Urology; St John of God Hospital and University Hospital Barwon Health; Geelong Vic. Australia
| | - Daniel A. Moon
- Department of Urology; Epworth Healthcare; Melbourne Vic. Australia
| | - Jason Ooi
- Department of Urology; St Vincents Private Hospital; East Melbourne Vic. Australia
| | - Tom Shannon
- Department of Urology; Hollywood Private Hospital; Perth WA Australia
| | - David Sofield
- Department of Urology; Bethesda Hospital; Perth WA Australia
| | | |
Collapse
|
4
|
Luke S, Delprado W, Louie-Johnsun M. Teaching laparoscopic radical prostatectomy during the primary surgeon's early learning curve - analysis of our first 207 cases. BJU Int 2014; 114 Suppl 1:38-44. [DOI: 10.1111/bju.12799] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Serge Luke
- Department of Urology; Gosford Hospital and Gosford Private Hospital; Gosford NSW Australia
| | | | - Mark Louie-Johnsun
- Department of Urology; Gosford Hospital and Gosford Private Hospital; Gosford NSW Australia
| |
Collapse
|
5
|
Current world literature. Curr Opin Urol 2012. [PMID: 23202289 DOI: 10.1097/mou.0b013e32835bb149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|