Serving as a bedside surgeon before performing robotic radical prostatectomy improves surgical outcomes
Int. braz. j. urol
; 45(6): 1122-1128, Nov.-Dec. 2019. tab
Article
em En
| LILACS
| ID: biblio-1056344
Biblioteca responsável:
BR1.1
ABSTRACT
ABSTRACT Introduction:
To evaluate the influence of previous experience as bedside assistants on patient selection, perioperative and pathological results in robot assisted laparoscopic radical prostatectomy. Materials andMethods:
The first 50 cases of two robotic surgeons were reviewed retrospectively. Group 1 consisted of the first 50 cases of the surgeon with previous experience as a robotic bedside assistant between September 2016-July 2018, while Group 2 included the first 50 cases of the surgeon with no bedside assistant experience between February 2009-December 2009. Groups were examined in terms of demographics, prostate volume, presence of median lobe, prostate specific antigen (PSA), preoperative Gleason score, positive core number, clinical stage, console surgery time, estimated blood loss, postoperative Gleason score, pathological stage, positive surgical margin rate, postoperative complications, length of hospital stay and biochemical recurrence rate.Results:
Previous abdominal surgery and the presence of median lobe hypertrophy rates were higher in Group 1 than in Group 2 (20% vs. 4%, p=0.014; 24% vs. 6%, p=0.012; respectively). In addition, patients in Group 1 were in a higher clinical stage than those in Group 2 (cT2 70% vs. 28%, p=0.001). Median console surgery time and median length of hospital stay was significantly shorter in Group 1 than in Group 2 (170 min vs. 240 min, p=0.001; 3 vs. 4, p=0.022; respectively). Clavien grade 3 complication rate was higher in Group 2 but was statistically insignificant.Conclusion:
Our findings might reflect that previous bedside assistant experience led to an increase in self-confidence and the ability to manage troubleshooting and made it more likely for surgeons to start with more difficult cases with more challenging patients. It is recommended that novice surgeons serve as bedside assistants before moving on to consoles.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Assunto principal:
Prostatectomia
/
Competência Clínica
/
Procedimentos Cirúrgicos Robóticos
Tipo de estudo:
Observational_studies
Limite:
Aged
/
Humans
/
Male
Idioma:
En
Revista:
Int. braz. j. urol
Assunto da revista:
UROLOGIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Turquia
País de publicação:
Brasil