Tags

Type your tag names separated by a space and hit enter

Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy.
J Urol. 2003 Nov; 170(5):1738-41.JU

Abstract

PURPOSE

For a skilled laparoscopic surgeon the learning curve for achieving proficiency with laparoscopic radical prostatectomy (LRP) is estimated at 40 to 60 cases. For the laparoscopically naïve surgeon the curve is estimated at 80 to 100 cases. The development of a robotic interface might significantly shorten the LRP learning curve for an experienced open yet naïve laparoscopic surgeon. To our knowledge we report the initial experience with robot assisted LRP of a surgeon without laparoscopic experience.

MATERIALS AND METHODS

Following a 1-day da Vinci (Intuitive Surgical, Mountain View, California) robotic laparoscopic training course and 2 cadaveric robotic LRPs an experienced oncologist (TEA) without laparoscopic experience performed 45 robotic LRPs.

RESULTS

All procedures were successfully completed laparoscopically with no rectal injuries or transfusions. The learning curve to 4-hour proficiency was 12 patients and mean operating time subsequently was 3.45 hours (range 2.5 to 5.1). Mean blood loss was 145 cc (range 25 to 350), the mean postoperative day 1 decrease in hemoglobin was 2.6 mg/dl (range 1.9% to 5.1) and mean hospital stay was 36 hours (range 18 to 168). Mean Gleason score was 6.8, mean prostate volume was 50.5 gm (range 12.5 to 163) and the margin positive rate was 35.5%. Four patients (8.8%) had a total of 6 complications, which were managed conservatively. Catheterization time was 7 days (range 7 to 42). Continence (0 pads) was 33% at 1 week, 63% at 1 month and 81% at 3 months.

CONCLUSIONS

A laparoscopically naïve yet experienced open surgeon successfully transferred open surgical skills to a laparoscopic environment in 8 to 12 cases using a robotic interface. This outcome is comparable to the reported experience of skilled laparoscopic surgeons after more than 100 LRPs.

Authors+Show Affiliations

Department of Urology, University of California-Irvine, UCI Medical Center, Orange, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

14532766

Citation

Ahlering, Thomas E., et al. "Successful Transfer of Open Surgical Skills to a Laparoscopic Environment Using a Robotic Interface: Initial Experience With Laparoscopic Radical Prostatectomy." The Journal of Urology, vol. 170, no. 5, 2003, pp. 1738-41.
Ahlering TE, Skarecky D, Lee D, et al. Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. J Urol. 2003;170(5):1738-41.
Ahlering, T. E., Skarecky, D., Lee, D., & Clayman, R. V. (2003). Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. The Journal of Urology, 170(5), 1738-41.
Ahlering TE, et al. Successful Transfer of Open Surgical Skills to a Laparoscopic Environment Using a Robotic Interface: Initial Experience With Laparoscopic Radical Prostatectomy. J Urol. 2003;170(5):1738-41. PubMed PMID: 14532766.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. AU - Ahlering,Thomas E, AU - Skarecky,Douglas, AU - Lee,David, AU - Clayman,Ralph V, PY - 2003/10/9/pubmed PY - 2003/12/3/medline PY - 2003/10/9/entrez SP - 1738 EP - 41 JF - The Journal of urology JO - J. Urol. VL - 170 IS - 5 N2 - PURPOSE: For a skilled laparoscopic surgeon the learning curve for achieving proficiency with laparoscopic radical prostatectomy (LRP) is estimated at 40 to 60 cases. For the laparoscopically naïve surgeon the curve is estimated at 80 to 100 cases. The development of a robotic interface might significantly shorten the LRP learning curve for an experienced open yet naïve laparoscopic surgeon. To our knowledge we report the initial experience with robot assisted LRP of a surgeon without laparoscopic experience. MATERIALS AND METHODS: Following a 1-day da Vinci (Intuitive Surgical, Mountain View, California) robotic laparoscopic training course and 2 cadaveric robotic LRPs an experienced oncologist (TEA) without laparoscopic experience performed 45 robotic LRPs. RESULTS: All procedures were successfully completed laparoscopically with no rectal injuries or transfusions. The learning curve to 4-hour proficiency was 12 patients and mean operating time subsequently was 3.45 hours (range 2.5 to 5.1). Mean blood loss was 145 cc (range 25 to 350), the mean postoperative day 1 decrease in hemoglobin was 2.6 mg/dl (range 1.9% to 5.1) and mean hospital stay was 36 hours (range 18 to 168). Mean Gleason score was 6.8, mean prostate volume was 50.5 gm (range 12.5 to 163) and the margin positive rate was 35.5%. Four patients (8.8%) had a total of 6 complications, which were managed conservatively. Catheterization time was 7 days (range 7 to 42). Continence (0 pads) was 33% at 1 week, 63% at 1 month and 81% at 3 months. CONCLUSIONS: A laparoscopically naïve yet experienced open surgeon successfully transferred open surgical skills to a laparoscopic environment in 8 to 12 cases using a robotic interface. This outcome is comparable to the reported experience of skilled laparoscopic surgeons after more than 100 LRPs. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/14532766/Successful_transfer_of_open_surgical_skills_to_a_laparoscopic_environment_using_a_robotic_interface:_initial_experience_with_laparoscopic_radical_prostatectomy_ L2 - https://www.jurology.com/doi/full/10.1097/01.ju.0000092881.24608.5e?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -