PD38-03 AUTOMATED PERFORMANCE METRICS DURING ROBOTIC-ASSISTED RADICAL PROSTATECTOMY CAN DIFFERENTIATE CLINICAL OUTCOME

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy V1 Apr 2018PD38-03 AUTOMATED PERFORMANCE METRICS DURING ROBOTIC-ASSISTED RADICAL PROSTATECTOMY CAN DIFFERENTIATE CLINICAL OUTCOME Andrew Hung, Paul Oh, Jian Chen, Nathan Cheng, Michael Lin-Brande, Micha Titus, Niero Rajarubendra, and Inderbir Gill Andrew HungAndrew Hung More articles by this author , Paul OhPaul Oh More articles by this author , Jian ChenJian Chen More articles by this author , Nathan ChengNathan Cheng More articles by this author , Michael Lin-BrandeMichael Lin-Brande More articles by this author , Micha TitusMicha Titus More articles by this author , Niero RajarubendraNiero Rajarubendra More articles by this author , and Inderbir GillInderbir Gill More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1750AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Surgical skill is associated with post-operative outcomes of patients. Our study utilized automated performance metrics (APMs) obtained by a novel recorder ″dVLogger″ during robotic-assisted prostatectomies (RRP) to assess contemporary skill and to see if such determination could distinguish clinical outcomes in historical cases. METHODS Automated performance metrics (instrument motion tracking metrics and system events) from 17 single-surgeon cases were recorded from 8 faculty surgeons (median: 2 cases/surgeon, range: 1-4). Based on a previous study at our institution where we showed that faster, more frequent camera usage correlated with greater surgeon experience, cases were stratified into two groups based on endoscopic camera velocity and frequency of camera manipulation during the whole RRP. Four surgeons were placed in Group 1 (optimal camera skill) and four surgeons in Group 2 (sub-optimal camera skill). Historical clinical data of these 8 surgeons from January to December 2016 was obtained from our institute′s IRB-approved database. Kruskal-Wallis and Chi-square test were used to determine differences in clinical data between groups. RESULTS 196 total historical cases were divided into Group 1 (n=125) and Group 2 (n=71) based on the surgeon′s contemporary performance using APMs (Table). There were no significant differences in patient demographics between groups (age, BMI, PSA, Gleason score, ASA). Group 1 was found to have shorter surgery time (224 vs. 245 minutes, p<0.01), decreased intra-abdominal drain duration (1 vs. 7 days, p<0.01), decreased Foley catheter duration (7 vs. 9 days, p<0.01), and less estimated blood loss (p=0.01). No differences were seen in positive margin rate, medical/surgical complications, or 6-month post-operative PSA, continence status, or erectile function (p>0.05). CONCLUSIONS A previous landmark bariatric study showed that surgical skill is associated with fewer post-operative complications, readmissions, and re-operations. Our analysis shows for the RRP, skilled surgeons with more efficient APMs experience superior intra- and post-operative outcomes, further highlighting the importance of robotic skill on patient outcomes in urologic surgery. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e736-e737 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Andrew Hung More articles by this author Paul Oh More articles by this author Jian Chen More articles by this author Nathan Cheng More articles by this author Michael Lin-Brande More articles by this author Micha Titus More articles by this author Niero Rajarubendra More articles by this author Inderbir Gill More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...