Laparoscopic radical prostatectomy: a single surgeon\u2019s experience in 80 cases after 2\xa0years of formal training

Sinan Çelen,Aykut Başer,Ömer Levent Tuncay,Aslı Mete,Ali Ersin Zümrütbaş,Yusuf Özlülerden

doi:10.1186/s12301-021-00159-5

Sinan Çelen, Aykut Başer + Show 4 more

Open Access

https://doi.org/10.1186/s12301-021-00159-5

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Abstract

BackgroundTo 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.MethodsThe 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.ResultsClinical 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.ConclusionsOur 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

Highlights

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
Total operating room time was calculated from the first insufflation on to the last trocar extraction, and the estimated blood loss (EBL) was assessed with the measurement of sucker bottle volumes
There were no significant differences among the groups in age, body mass index, prostate-specific antigen (PSA), and American Society of Anaesthesiologists (ASA) scores (Table 1)

Summary

Introduction

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. Radical prostatectomy is the most widely performed surgical treatment for localized and locally advanced prostate cancer. The use of conventional laparoscopy to perform a radical prostatectomy decreased after the invention and widespread use of robot technology, because of the high. The historical evolution of laparoscopic radical prostatectomy (LRP) started with the transperitoneal technique (TLRP), which was performed in 1997 and later, extraperitoneal laparoscopic radical prostatectomy (ELRP) was successfully applied [1,2].

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