Learning curve with robotic-assisted laparoscopic radical prostatectomy: A prospective study
- Authors
- Ban, J.H.; Ko, Y.K.; Kang, S.H.; Park, H.S.; Cheon, J.
- Issue Date
- 2009
- Keywords
- Laparoscopy; Prostatectomy; Prostatic neoplasms; Robotics
- Citation
- Korean Journal of Urology, v.50, no.2, pp.140 - 147
- Indexed
- SCOPUS
KCI
- Journal Title
- Korean Journal of Urology
- Volume
- 50
- Number
- 2
- Start Page
- 140
- End Page
- 147
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/121916
- DOI
- 10.4111/kju.2009.50.2.140
- ISSN
- 2005-6737
- 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. © The Korean Urological Association, 2009.
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