The surgical learning curve of robotic-assisted laparoscopic radical prostatectomy

Abstract

Objective To investigate the surgical learning curve of robotic-assisted laparoscopic radical prostatectomy (RALP). Methods The data of the first 80 RALP patients, who were admitted to our hospital between May 2015 and May 2017. All of the operations were done by two surgeons independently. According to the operation sequence, the 80 cases were divided into four groups, including Group A(1st to 20th), Group B(21st to 40th), Group C(41st to 60th) and Group D(61st to 80th).The mean age of patients was 67 years (range 44 to 78 years), median serum PSA level was 12.27 μg/L (range 0.48 to 247.00 μg/L). The cases staged T1, T2 or higher were 14, 47 and 19, respectively. The operative time, intraoperative hemorrhage volume, postoperative hospital stay and catheterization time were statistically analyzed. Results Surgical procedures were successfully completed in all groups. No patient was turned to open surgery. The mean operative time was 240 min (range 130 to 480 min). The median intraoperative hemorrhage volume was 100 ml (range 10 to 1500 ml). The mean catheterization time was 16.2 days (range 7 to 36 days). Postoperative of hospital stay averaged 10.3 days (range 4 to 22 days). Comparing with Group A, the operative and catheterization time were obviously decreased in the last three groups (P<0.05). Moreover, the operative time and the intraoperative hemorrhage volume also reached the plateau of learning curve after 20 cases. More and more high risk patients in last 40 cases. Conclusion There is an obvious learning curve in the study process of RALP. After reaching the plateau of the learning curve, surgeons could generally try to conduct operations with more difficulty. Key words: Robot; Learning curve; Prostate cancer; Prostatectomy; Retrospective