Learning robotic pyeloplasty without simulators: an assessment of the learning curve in the early robotic era

Abstract

OBJECTIVE: To analyze our experience and learning curve for robotic pyeloplasty during this robotic procedure. METHODS: Ninety-nine patients underwent 100 consecutive procedures. Cases were divided into 4 groups of 25 consecutive procedures to analyze the learning curve. RESULTS: The median anastomosis times were 50.0, 36.8, 34.2 and 29.0 minutes ( p =0.137) in the sequential groups, respectively. The median operative times were 144.6, 119.2, 114.5 and 94.6 minutes, with a significant difference between groups 1 and 2 ( p =0.015), 1 and 3 ( p =0.002), 1 and 4 ( p <0.001) and 2 and 4 ( p =0.022). The mean hospital stay was 7.08, 4.76, 4.88 and 4.20 days, with a difference between groups 1 and 2 ( p <0.001), 1 and 3 ( p <0.001) and 1 and 4 ( p <0.001). Clinical and radiological improvements were observed in 98.9% of patients. One patient presented with recurrent obstruction. CONCLUSIONS: Our results demonstrate a high success rate with low complication rates. A significant decrease in hospital stay and surgical time was evident after 25 cases.

<p>Comparison of Safety, Efficacy and Outcomes of Robot Assisted Laparoscopic Pyeloplasty vs Conventional Laparoscopy</p>

“…Most of the authors found out that the learning curve of LP and RALP steadily decreased with collective surgical experience. 51 , 52 Chammas MF et al 53 evaluated 99 patients who had undergone 100 consecutive robotic procedures. Cases were divided into 4 groups of 25 consecutive procedures to analyse the learning curve.…”