Trainees Do Not Negatively Impact the Institutional Learning Curve for Robotic Prostatectomy as Characterized by Operative Time, Estimated Blood Loss, and Positive Surgical Margin Rate

Schroeck, Florian R.; Sousa, Chiquita A. Palha De; Kalman, Ross A.; Kalia, Maitri S; Pierre, Sean A.; Haleblian, George E.; Sun, Leon; Moul, Judd W.; Albala, David

doi:10.1016/j.urology.2007.12.023

Cited by 84 publications

(53 citation statements)

References 19 publications

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“…We report only short-term easily obtainable outcomes, while collecting data on long-term quality-of-life outcomes. Safety has also been reported by the study by Schroeck et al [16], who showed no difference in estimated blood loss and PSM rates in a training centre.…”

Section: Discussionsupporting

confidence: 65%

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Initial experience of teaching robot‐assisted radical prostatectomy to surgeons‐in‐training: can training be evaluated and standardized?

et al. 2010

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divided into 11 steps, and staff times were recorded for each step. Trainee times and quality scores were recorded for each step, the later defined as grade A equal to staff (A + , no verbal coaching); B, minor corrections; and C, major corrections. Shortterm outcomes were recorded to assess the safety of the training. RESULTSThe mean (range) console time/case of trainees was 40 (10-123) min. The median console time for a complete case by faculty and by trainees (pooled group) was 128 and 231 min, respectively, an increase in 81%. Individual trainee-performed steps increased in time (compared to staff) by a median range of 50-177%, and the incidence of quality grades < A of 9-100%. Trainee quality grades for basic tissue-dissection steps were higher than for advanced tissue dissection and suturing. There was no downgrading for a major correction. Analysis of short-term outcomes suggested acceptable results in a training environment. The study is limited by no available validated training measurement tools, and a low frequency of beginner trainees advancing to more difficult steps during the rotation. CONCLUSIONSDuring the initial exposure of trainees to RARP of < 40 cases, we measured time and subjective quality grading of basic steps, and introduction to advanced steps. Training requires more procedure time, but does not appear to diminish expected outcomes.

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Section: Discussionsupporting

confidence: 65%

“…The study of Schroeck et al [16] also sought to study the results of RARP in a training centre, and is the first published report on this topic. Their design was different from ours, in that the procedure was divided sequentially into thirds and trainees were advanced in order from assistant only to part one, three, and then two.…”

Section: Discussionmentioning

confidence: 99%

Initial experience of teaching robot‐assisted radical prostatectomy to surgeons‐in‐training: can training be evaluated and standardized?

et al. 2010

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show abstract

“…They concluded that previous purported concerns with respect to oncological outcomes as a result of lack of tactile feedback were unfounded. Schroeck et al [20] evaluated the learning curves and perioperative outcomes of an experienced laparoscopic surgeon and his trainees to gain some insight into the question of whether trainees negatively impact on the institutional learning curve for robotic prostatectomy as characterized by operative time, estimated blood loss, and positive surgical margin rate. They concluded that a structured teaching program for RALP is effective and that trainees did not negatively affect the estimated blood loss and positive surgical margin rate.…”

Section: Trainee Impact On Patient Outcomesmentioning

confidence: 99%