Please use this identifier to cite or link to this item: https://hdl.handle.net/1/1052
Title: Teaching laparoscopic radical prostatectomy during the primary surgeon's early learning curve--analysis of our first 207 cases
Authors: Louie-Johnsun, Mark ;Luke, Serge ;Delprado, W.
Issue Date: Nov-2014
Source: Volume 114 Suppl 1, pp. 38 - 44
Journal title: BJU International
Abstract: OBJECTIVE: To assess the feasibility of introducing laparoscopic radical prostatectomy (LRP) training during the primary surgeon's early learning curve in a regional Australian centre. PATIENTS AND METHODS: From a prospective single surgeon database perioperative, oncological and functional outcome data was collected from the first 207 consecutive patients who underwent LRP immediately after a 12-month LRP Fellowship in a high-volume centre by the primary surgeon (M.L.J.). A training case was defined as the successful completion of at least two of 10 steps by a training Fellow. Perioperative and oncological outcomes were compared in training and non-training cohorts and overall learning curve was assessed by comparing consecutive 50-patient cohorts. RESULTS: In all, 31% of cases were training cases with a median (range) of 7 (2-10) steps of 10 steps performed by the training Fellow. Operative times were significantly longer in training cases (mean 269 vs 209 min; P < 0.001). There was no statistically significant difference in perioperative outcomes of length of stay (2.7 vs 2.6 days), transfusion rates (3.1% vs 2.1%), major complication (Clavien >3a) rates (1.6% vs 2.1%) or positive surgical margins (PSMs: pT2 2.8% vs 15.3% and pT3 52.0% vs 45.1%) between training and non-training groups, respectively. Overall, there were two open conversions (1.0%). CONCLUSION: Despite the challenging learning curve, LRP training can be commenced safely with a stepwise modular approach, even when the primary surgeon is in their early learning curve. Perioperative outcomes including PSMs and major complications were unaffected by trainee involvement.
URI: https://elibrary.cclhd.health.nsw.gov.au/cclhdjspui/handle/1/1052
DOI: 10.1111/bju.12799
Pubmed: https://www.ncbi.nlm.nih.gov/pubmed/24825242
ISSN: 1464-4096
Publicaton type: Journal Article
Keywords: Cancer
Study or Trial: Prospective Cohort Study
Appears in Collections:Health Service Research

Show full item record

Page view(s)

24
checked on Jan 27, 2023

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.