Learning Curve of an Innovative “3-Port” Laparoscopic Radical Prostatectomy: A Single-Center Analysis from 2016 to 2019

Abstract

<b><i>Background:</i></b> “Three-port” laparoscopic radical prostatectomy (LRP) has been applied as a substitution for the conventional 4- to 5-port LRP to treat prostate cancer (PCa) patients in our institution. <b><i>Objective:</i></b> To evaluate the learning curve of an innovative “3-port” LRP for PCa patients. <b><i>Methods:</i></b> 206 patients who received “3-port” LRP were retrospectively reviewed between January 2016 and December 2019 at our institution. According to the different years of operations performed, all of the patients were divided into group A (No. 1–50), group B (No. 51–107), group C (No. 108–160), and group D (No. 161–206). A learning curve was depicted by analyzing the parameters of operative time (OT), estimated blood loss (EBL), hospitalization, and drainage indwelling days. <b><i>Results:</i></b> All groups were comparable with regard to the preoperative characteristics (<i>p</i> > 0.05). The sloping learning curve for the surgeon showed that OT and EBL were strongly correlated with an accumulated experience when compared between group A and the other groups (<i>p</i> < 0.05), denoting that the surgical skill of the “3-port” LRP can be fully mastered after around 50 cases. Although no significant correlation with additional experience was observed in the hospitalization and drainage indwelling days among groups, a tendency towards less hospitalization and drainage indwelling days was still reflected. <b><i>Conclusions:</i></b> Our 4-year analysis based on a single-center experience exhibits that the innovative “3-port” LRP appears to be favorable with decreasing tendency in OT and EBL with experience accumulation. In view of its advantage of perioperative parameters with an evidently improved learning curve, it should be recommended in the clinical practice!

Three-port approach vs conventional laparoscopic radical cystectomy with orthotopic neobladder: a single-center retrospective study

“…Innovations such as three-port LRC to reduce the number of cannulas have been used in other urological procedures. Xu et al [ 23 – 25 ] performed several cases of three-port laparoscopic radical prostatectomy (LRP). Their study successfully demonstrated that three-port LRP has significant advantages in terms of perioperative data such as operation time and intraoperative blood loss compared with traditional surgery, which is worthy of popularization and application.…”