Determining the Learning Curve for Robot-Assisted Simple Prostatectomy in Surgeons Familiar with Robotic Surgery

Johnson, Brett A.; Sorokin, Igor; Singla, Nirmish; Roehrborn, Claus G.; Gahan, Jeffrey

doi:10.1089/end.2018.0377

Cited by 43 publications

(25 citation statements)

References 19 publications

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“…They collected HoLEP data from different centers. Johnson et al [33] conducted a study to determine the learning curve for RASP and reported that 10-12 cases may be required for somebody with robotic experience to become proficient for RASP. On the other hand, Brunckhorst et al [50] estimated 40-60 cases to be enough for HoLEP surgery.…”

Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Simple Prostatectomy: A Systematic Review

Kordan

Canda

Köseoğlu

et al. 2020

JCM

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Contemporary minimally invasive surgical (MIS) treatment options of patients with male Lower Urinary Tract Symptoms (LUTS) in men with prostate glands >80 mL include Holmium Laser Enucleation Prostate (HoLEP), Thulium laser VapoEnucleation Prostate (ThuVEP), and Laparoscopic (LSP) or Robotic-Assisted Simple Prostatectomy (RASP). Implementing new laser technologies is costly, and the steep learning curve of these laser techniques limit their wide range use. This promoted the use of LSP and RASP in centers with readily established laparoscopy or robotic surgery programs. The aim of this study is to review case and comparative series of RASP. We systematically reviewed published data from 2008 to 2020 on RASP and have identified 26 non-comparative and 9 comparative case series. RASP has longer operation time but less time spent in hospital and less blood loss. The outcomes of improvements in symptom score, post-voiding residual urine (PVR), postoperative PSA decline, complications, and cost are similar when compared to open and laser enucleation techniques. These outcomes position RASP as a viable MIS treatment option for patients with male LUTS needing surgical treatment for enlarged prostates. Nevertheless, prospective, randomized controlled trials (RCTs) with multicenter and large sample size are needed to confirm the findings of this systematic review.

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Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Simple Prostatectomy: A Systematic Review

Kordan

Canda

Köseoğlu

et al. 2020

JCM

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“…However, considering that reports on other comparators such as HoLEP presented results from the most experienced surgeons, further improvements in the operation time of RSP are expected, since we are still in the early reporting stage. The learning curve of RSP is relatively short, at 10-12 cases [3]. In particular, surgeons with experience in robotic pelvic surgery can perform the operation without any difficulty, because the pelvic anatomy is already familiar, and there is a low risk of requiring transfusion or experiencing major perioperative complications, even for beginners.…”

Section: Discussionmentioning

confidence: 99%

“…3). Four series were comparative studies and remaining 3 series were noncomparative studies [3,4,[18][19][20][21][22]. One series analyzed and reported the results of 2 different RSP techniques separately [19].…”

Section: Literature Reviewmentioning

confidence: 99%

“…Regarding functional outcomes, patients showed significant improvements in maximum flow rate and the International Prostate Symptom Score (IPSS) at postoperative follow-up examinations. The 3 series reported incidental prostate cancer rates of 0.8%-11% [3,19,20].…”

Section: Literature Reviewmentioning

confidence: 99%

“…Surgery for large benign prostatic hyperplasia (BPH) weighing 80-100 g or more poses a major challenge for surgeons. Open simple prostatectomy (OSP), which has been considered the treatment of choice, has a risk of invasiveness and bleeding, and holmium laser enucleation of the prostate (HoLEP), which has recently been in the spotlight, needs special equipment and has problems with a steep learning curve and transient stress urinary incontinence (SUI) that can remain present for a relatively long time [1][2][3]. Robot-assisted laparoscopic surgery-as exemplified by the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA)-has been commercialized worldwide, and many institutions are expanding its indications for both malignant and benign diseases.…”

Section: Introductionmentioning

confidence: 99%

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Robotic Simple Prostatectomy: Why and How?

2020

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Increasingly many studies have presented robotic simple prostatectomy (RSP) as a surgical treatment option for large benign prostatic hyperplasia (BPH) weighing 80–100 g or more. In this review, some frequently used RSP techniques are described, along with an analysis of the literature on the efficacy and complications of RSP and differences in treatment results compared with other surgical methods. RSP has the advantage of a short learning curve for surgeons with experience in robotic surgery. Severe complications are rare in patients who undergo RSP, and RSP facilitates the simultaneous treatment of important comorbid diseases such as bladder stones and bladder diverticula. In conclusion, RSP can be recommended as a safe and effective minimally invasive treatment for large BPH.

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Outcomes of robotic modified Freyer's prostatectomy in an Australian patient cohort

et al. 2023

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IntroductionThe study aims to demonstrate the feasibility, safety and efficacy of robotic simple prostatectomy (RSP) using the modified Freyer's approach in an Australian patient cohort. Although RSP is performed in several Australian centres, there is a paucity of published Australian data.MethodsWe reviewed prospectively collected perioperative and outcomes data for patients who underwent a robotic modified Freyer's prostatectomy (RMFP) from June 2019 to March 2022. Statistics were completed using SPSS statistics v27.0 and reported as mean and range with a p value of <0.05 considered statistically significant.ResultsThere were 27 patients who underwent RMFP over the study period with a mean age of 67 years and prostate volume of 159.74 cc (100–275). The mean console time was 168 min (122–211), blood loss of 233 ml (50–600) and average length of hospital stay of 3.8 days (3–8). The preoperative versus postoperative outcome means were as follows: serum prostate‐specific antigen was 9.69 versus 1.2 ng/mL, IPPS score was 17.1 versus 1.25, quality of life (QOL) score 3.4 versus 0.4, postvoid residual volume: 223.6 versus 55.9 ml, Q‐max 7.86 versus 29.6 ml/s. These were all statistically significant (p < 0.001). The mean weight of resected tissue was 74 g (43–206) with 25 patients having benign histopathology and two being diagnosed with prostate cancer (Gleason 3 + 3 = 6 and 3 + 4 = 7). No patients returned to theatre or required a blood transfusion.ConclusionsData from our patient cohort demonstrate the feasibility, safety and efficacy of RMFP for benign prostatic hyperplasia in an Australian patient cohort. Our outcomes compare favourably with published studies on RSP.

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Determining the Learning Curve for Robot-Assisted Simple Prostatectomy in Surgeons Familiar with Robotic Surgery

Cited by 43 publications

References 19 publications

Robotic-Assisted Simple Prostatectomy: A Systematic Review

Robotic-Assisted Simple Prostatectomy: A Systematic Review

Robotic Simple Prostatectomy: Why and How?

Outcomes of robotic modified Freyer's prostatectomy in an Australian patient cohort

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