Determining the component-based operative time learning curve for robotic-assisted radical prostatectomy

作     者：David Ambinder Shu Wang Mohummad Minhaj Siddiqui 

作者机构：Division of UrologyDepartment of SurgeryUniversity of Maryland School of MedicineBaltimoreMDUSA 

出 版 物：《Current Urology》 (当代泌尿学（英文）)

年 卷 期：2022年第16卷第4期

页      面：240-245页

学科分类：1002[医学-临床医学] 08[工学] 081101[工学-控制理论与控制工程] 0811[工学-控制科学与工程] 081102[工学-检测技术与自动化装置] 

主　　题：Cumulative sum(CUSUM)analysis Learning curve Prostate cancer Robotic-assisted radical prostatectomy 

摘      要：Objectives:To determine the learning curve(LC)of total operative time and the discrete components of the robotic-assisted radical prostatectomy(RARP)for a recent robotic fellowship-trained urologic *** and methods:We performed a retrospective analysis of RARP procedures performed by a single new attending surgeon from August 2015 to April *** demographics and operative details were *** operative time was divided and prospectively recorded in 7 parts:(a)docking robot,(b)dissecting seminal vesicles(SVs)(c)dissecting endopelvic fascia(EPF),(d)incising bladder neck(BN),(e)completing the dissection,(f)lymph node dissection,and(g)urethrovesical anastomosis(UVA)and robot *** sum analysis was used to ascertain the LC for total operative time and the 7 parts of the ***:One hundred twenty consecutive RARPs were *** LC was overcome at 25 cases for total operative time,13 cases for docking the robot,33 cases for dissecting SVs,31 cases for dissecting EPF,46 cases for incising BN,38 cases for prostate dissection,25 cases for lymph node dissection,and 52 cases for *** operative time was decreased 22.8%(p0.0001)and time for robot docking,dissecting SVs,dissecting EPF,incising BN,completing prostate dissection,lymph node dissection,and UVA were decreased 16.7%,30.5%,29.5%,36.2%,37.3%,32.2%,and 26.9%,respectively(all p0.05).Conclusions:We observed a 25-case LC for a fellowship-trained urologist to achieve stable operative performance of RARP *** components demonstrated variable LCs including the UVA that required upward of 52 cases.