Videotaping of surgical procedures and outcomes following extraperitoneal laparoscopic radical prostatectomy for clinically localized prostate cancer

Abstract

Background Video‐recording of emerging minimally invasive surgical procedures is likely to become an integral component of patient record‐keeping in the future for prostate cancer treatment. No prior work has shown the impact of videotaping of laparoscopic prostatectomy on patient outcomes. Our aim was to determine correlation between independent peer review of videotaping quality scores of extraperitoneal laparoscopic prostatectomy (ELRP) with complications, re‐admissions, functional, and early oncological outcomes. Study Design, Setting, and Participants We conducted a single‐institution prospective cohort study comparing videotaping quality scores with the outcomes of ELRP in men with localized prostate cancer. Videotaping of surgical procedures were scored by two experienced laparoscopic surgeons using a validated scoring method. Validated record‐linkage methodology and self‐reported questionnaires were used to assess surgical complications, re‐admissions, functional, and oncological outcomes based on a common identifier called as community health index (CHI) number. Pearson correlation coefficients were calculated between the different covariates with statistical significance considered at P < 0.05. Multivariate analyses assessed oncological outcomes (positive surgical margins/biochemical recurrence), post‐operative complications, and re‐admission into hospital following initial hospital discharge with quality of surgical procedure. Results 200 men were recruited into the study. 51 (25.5%) participants had post‐operative complications. Record‐linkage methodology identified 18 (9%) participants had re‐admissions within 90 days of the procedure. 13 (6.5%) of these men required percutaneous drainage with hospital stay following re‐admissions ranged between 3 and 12 days. 10 (5.0%) participants had intra/peri‐operative complications. 23 (11.5%) men reported to primary care physicians for various indications. Higher quality surgical technique videotaped scores (assessed by independent peer review) had a significant correlation with early continence recovery at 3 months post‐procedure, (P = 0.013), but lost statistical significance with overall continence at 1 year. No statistical correlation was observed between videotaped scores and oncological outcomes (positive surgical margins/biochemical recurrence), post‐operative complications, and readmission into hospital. Conclusions Quality of surgical procedure assessed by independent third party videotaping score predicted early resumption of continence following extraperitoenal laparoscopic radical prostatectomy, however, it did not predict complications, oncological or functional outcome as assessed using patient reported outcomes at 12 months. J. Surg. Oncol. 2016;114:1016–1023. © 2016 Wiley Periodicals, Inc.

The association between the outcomes of extraperitoneal laparoscopic radical prostatectomy and the anthropometric measurements of the prostate by magnetic resonance imaging

“…Finally, the most challenging laparoscopic surgery in Urology is ELRP ( 16 ). Birkmeyer et al reported a variation in surgeon's technical skill based on peer-rated video-recording ( 17 ). Moreover, many studies reflect that during the learning curve a significant reduction in the average time to perform the urethral-bladder anastomosis, the estimated blood loss and the removal time of the urinary catheter have not caused any important complication while performing ELRP ( 3 , 18 ).…”