Learning curve for radical retropubic prostatectomy

Saito, Fernando J.; Dall’Oglio, Marcos F.; Ebaid, Gustavo; Bruschini, Homero; Chade, Daher C.; Srougi, Miguel

doi:10.1590/s1677-55382011000100009

Cited by 17 publications

(13 citation statements)

References 21 publications

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“…Three studies investigated the learning curve for both open and LRP, while one study evaluated the learning curve for perineal prostatectomy (Table ). Vickers et al.…”

Section: Resultsmentioning

confidence: 99%

Learning curves for urological procedures: a systematic review

et al. 2013

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Objective• To determine the number of cases a urological surgeon must complete to achieve proficiency for various urological procedures. Patient and Methods• The MEDLINE, EMBASE and PsycINFO databases were systematically searched for studies published up to December 2011.• Studies pertaining to learning curves of urological procedures were included.• Two reviewers independently identified potentially relevant articles.• Procedure name, statistical analysis, procedure setting, number of participants, outcomes and learning curves were analysed. Results• Forty-four studies described the learning curve for different urological procedures.• The learning curve for open radical prostatectomy ranged from 250 to 1000 cases and for laparoscopic radical prostatectomy from 200 to 750 cases.• The learning curve for robot-assisted laparoscopic prostatectomy (RALP) has been reported to be 40 procedures as a minimum number.• Robot-assisted radical cystectomy has a documented learning curve of 16-30 cases, depending on which outcome variable is measured.• Irrespective of previous laparoscopic experience, there is a significant reduction in operating time (P = 0.008), estimated blood loss (P = 0.008) and complication rates (P = 0.042) after 100 RALPs. Conclusions• The available literature can act as a guide to the learning curves of trainee urologists. Although the learning curve may vary among individual surgeons, a consensus should exist for the minimum number of cases to achieve proficiency.• The complexities associated with defining procedural competence are vast.• The majority of learning curve trials have focused on the latest surgical techniques and there is a paucity of data pertaining to basic urological procedures.

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“…Three studies investigated the learning curve for both open and LRP, while one study evaluated the learning curve for perineal prostatectomy (Table ). Vickers et al.…”

Section: Resultsmentioning

confidence: 99%

Learning curves for urological procedures: a systematic review

et al. 2013

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“…[9] In this sense, several factors may play an important role in the learning curve, including those related to the surgeon, such as confidence and experience with other surgical procedures, as well as those related to the team members involved in the procedures. The number of cases performed by the surgeon and the volume of surgeries in a given center may undoubtedly delineate the course of surgical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the learning curve for transurethral resection of the prostate. Is there any influence of musical instrument and video game skills on surgical performance?

Yamaçake

Nakano

Soares

et al. 2015

Turkish Journal of Urology

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Objective: To evaluate the learning curve for transurethral resection of the prostate (TURP) among urology residents and study the impact of video game and musical instrument playing abilities on its performance. Material and methods:A prospective study was performed from July 2009 to January 2013 with patients submitted to TURP for benign prostatic hyperplasia. Fourteen residents operated on 324 patients. The following parameters were analyzed: age, prostate-specific antigen levels, prostate weight on ultrasound, preand postoperative serum sodium and hemoglobin levels, weight of resected tissue, operation time, speed of resection, and incidence of capsular lesions. Gender, handedness, and prior musical instrument and video game playing experience were recorded using survey responses. Results:The mean resection speed in the first 10 procedures was 0.36 g/min and reached a mean of 0.51 g/min after the 20 th procedure. The incidence of capsular lesions decreased progressively. The operation time decreased progressively for each subgroup regardless of the difference in the weight of tissue resected. Those experienced in playing video games presented superior resection speed (0.45 g/min) when compared with the novice (0.35 g/min) and intermediate (0.38 g/min) groups (p= 0.112). Musical instrument playing abilities did not affect the surgical performance. Conclusion:Speed of resection, weight of resected tissue, and percentage of resected tissue improve significantly and the incidence of capsular lesions reduces after the performance of 10 TURP procedures. Experience in playing video games or musical instruments does not have a significant effect on outcomes.

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“…Studies have shown that the number of cases required to develop proficiency in this procedure is of the order of 250–1000 . During this learning curve, positive surgical margins (PSMs) and resultant oncological outcomes have been shown to be inferior …”

Section: Introductionmentioning

confidence: 99%