Document Detail


Impact of robotic training on surgical and pathologic outcomes during robot-assisted laparoscopic radical prostatectomy.
MedLine Citation:
PMID:  20206971     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To prospectively compare outcomes during robotic prostatectomy between surgeons with formal training in either robotic prostatectomy (RALP) or laparoscopic prostatectomy (LRP). METHODS: A total of 286 robotic prostatectomies were performed by 12 urologists between August 2008 and March 2009 as part of a new robotic surgery program at one of the largest health maintenance organizations in the United States. Four surgeons had formal training in RALP and 8 had formal training in LRP. We prospectively compared surgical and pathologic outcomes between these 2 groups of surgeons. RESULTS: The 4 RALP surgeons performed 121 RALPs and the 8 LRP surgeons performed 165 RALPs. Patient demographics were similar between groups. The robot-naive group had significantly more clinical stage T1c than the robot-trained group (87.9% vs 74.4%, P = .003). Prostatectomy parameters were similar between the 2 groups of surgeons in terms of prostate size, Gleason score, pathologic stage, and estimated blood loss. The robot-trained surgeons had significantly lower overall positive margin rates (24% vs 34.6%, P = .05) and lower margin rates in T3 tumors (38.5% vs 61.8%, P = .07), which were approximately statistically significant. There was no difference in margin rates in T2 tumors. The robot-trained surgeons had significantly lower apical margin rates (8.3% vs 21.2%, P = .003) and lateral margin rates (1.7% vs 7.3%, P = .05). The robot-trained surgeons had 10%-15% shorter procedure times. There was no difference in complication rates. CONCLUSIONS: Formal RALP training may be beneficial for surgical and pathologic outcomes of RALP compared with formal LRP training during the initial implementation of a new robotics program.
Authors:
Eric O Kwon; Tricia C Bautista; Howard Jung; Reza Z Goharderakhshan; Stephen G Williams; Gary W Chien
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-03-05
Journal Detail:
Title:  Urology     Volume:  76     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-10     Completed Date:  2010-09-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  363-8     Citation Subset:  IM    
Copyright Information:
Copyright 2010. Published by Elsevier Inc.
Affiliation:
Department of Urology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA. erickwon@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Humans
Laparoscopy / methods*,  standards
Middle Aged
Prospective Studies
Prostatectomy / education*,  methods*,  standards
Robotics / education*
Treatment Outcome
Comments/Corrections
Comment In:
Urology. 2010 Aug;76(2):368-9; discussion 369   [PMID:  20696341 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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