Learning Curve with Robotic-Assisted Laparoscopic Radical Prostatectomy: A Prospective Study.
10.4111/kju.2009.50.2.140
- Author:
Jeong Hyeon BAN
1
;
Young Hwii KO
;
Seok Ho KANG
;
Hong Seok PARK
;
Jun CHEON
Author Information
1. Department of Urology, Korea University College of Medicine, Seoul, Korea. jcheon@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Prostatic neoplasms;
Prostatectomy;
Robotics;
Laparoscopy
- MeSH:
Humans;
Laparoscopy;
Learning;
Learning Curve;
Prospective Studies;
Prostatectomy;
Prostatic Neoplasms;
Robotics
- From:Korean Journal of Urology
2009;50(2):140-147
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To investigate the learning curve and its characteristics in our initial experiences with robotic-assisted laparoscopic radical prostatectomy (RLRP) with a new da Vinci-S surgical system. MATERIALS AND METHODS: Through inspection of the patients who underwent RLRP by a single urologic surgeon from July 2007 to May 2008, the variables related to surgery were evaluated prospectively. RESULTS: RLRP was performed in 50 patients. The patients' mean age (range) was 63 years (50-73 years), and 11 patients had a history of previous abdominal surgery. The mean total operation time was 281.6 min (190-455 min). The mean set-up time was 18.6 min (14-30 min), and the mean console time was 219.8 min (150-400 min). The mean estimated blood loss (EBL) was 375.7ml (200-800 ml). The overall margin-positive rate was 26% (13/50); it was 11.9% (5/42) for pT2 tumors and 100% (8/8) for pT3 tumors. Minor complications occurred in 5 patients. All complications were treated effectively with only conservative management. The total operation time, set-up time, console time, and EBL significantly decreased as the number of patients treated grew (Spearman's rank correlation, p<0.05; Rho=-0.49, -0.35, -0.54, -0.75, respectively). The mean total operation time, set-up time, console time, and EBL were significantly decreased in the last 35 patients who needed no transfusion (p<0.05). CONCLUSIONS: The use of robotic surgery allowed the surgeon to complete the learning curve in a relatively short time period, with low perioperative complication rates and potentially good oncologic results, as indicated by the acceptable positive surgical margin in the patients with pathologically organ-confined disease.
