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Initial surgical performance in robot-assisted radical prostatectomy is associated with clinical outcomes and learning curves.
Yamazaki, Masahiro; Kawahira, Hiroshi; Maeda, Yoshitaka; Oiwa, Kosuke; Yokoyama, Hirotaka; Kameda, Tomohiro; Kamei, Jun; Sugihara, Toru; Ando, Satoshi; Fujimura, Tetsuya.
Afiliação
  • Yamazaki M; Department of Urology, Sano Kosei General Hospital, Tochigi, Japan.
  • Kawahira H; Department of Urology, Jichi Medical University, Tochigi, Japan.
  • Maeda Y; Medical Simulation Center, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan. kawahira@jichi.ac.jp.
  • Oiwa K; Medical Simulation Center, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan.
  • Yokoyama H; Department of Information and Management Systems Engineering, Nagaoka University of Technology, Niigata, Japan.
  • Kameda T; Department of Urology, Jichi Medical University, Tochigi, Japan.
  • Kamei J; Department of Urology, Haga Red Cross Hospital, Tochigi, Japan.
  • Sugihara T; Department of Urology, Jichi Medical University, Tochigi, Japan.
  • Ando S; Department of Urology, Haga Red Cross Hospital, Tochigi, Japan.
  • Fujimura T; Department of Urology, Jichi Medical University, Tochigi, Japan.
Surg Endosc ; 38(10): 5634-5642, 2024 Oct.
Article em En | MEDLINE | ID: mdl-39107479
ABSTRACT

BACKGROUND:

The association between surgical performance ratings and clinical outcomes in robotic surgery is poorly understood. Additionally, no studies have reported on the relationship between the surgeon's initial case-skill evaluation and the learning curve in robot-assisted surgery. We evaluated whether an objective surgical technique evaluation score for initial robot-assisted radical prostatectomy (RARP) was associated with clinical outcomes and surgeons' learning curves.

METHODS:

Six surgeons who were trained in and started to perform RARP at our institution were included. Anonymized, unedited videos of each surgeon's 10th RARP case were evaluated by three reviewers, using modified Objective Structured Assessment of Technical Skill (OSATS) scores. We then divided the surgeons into two groups on the basis of these OSATS scores. We retrospectively compared the clinical outcomes and learning curves of the console time of the two groups for consecutive RARPs, performed from March 2018 to July 2023.

RESULTS:

We analyzed 258 RARPs (43 cases/surgeon), including 129 cases performed by high-OSATS score surgeons (18.2-19.3 points) and 129 cases performed by low-OSATS score surgeons (11.9-16.0 points). Overall, the high-OSATS score group had significantly shorter operation and console times than the low-OSATS score group did (both P < 0.01) and their patients' rate of continence recovery by 3 months post-RARP was significantly higher (P = 0.03). However, complications, blood loss, and positive margins did not differ between the groups (P = 0.08, P = 0.51, and P = 0.90, respectively). The high-OSATS score group had a significantly shorter console time than the low-OSATS score group did after the 11-20 cases.

CONCLUSIONS:

The OSATS score in early RARP cases can predict subsequent surgical outcomes and surgeons' learning curves.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Prostatectomia / Neoplasias da Próstata / Competência Clínica / Curva de Aprendizado / Procedimentos Cirúrgicos Robóticos Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Prostatectomia / Neoplasias da Próstata / Competência Clínica / Curva de Aprendizado / Procedimentos Cirúrgicos Robóticos Idioma: En Ano de publicação: 2024 Tipo de documento: Article