Learning Curve of Laparoscopic Radical Prostatectomy in a University Teaching Hospital: Experience after the First 600 Cases☆

Abstract Objectives To review features of initial and subsequent learning curves of laparoscopic radical prostatectomy (LRP). Methods A total of 604 patients underwent LRP. Two surgeons started the programme. After the completion of the first 103 cases, three generations of surgeons entered the programme stepwise. Thirty-four patients were operated by four different surgeons, with limited laparoscopic experience, and were considered as a single, separate group for analysis. Patient data, operating data, intraoperative and postoperative complications, and positive surgical margins were analysed chronologically for the whole group and for each surgeon. Results Mean operating time (201.5±68.0min), estimated blood loss (346.7±351.7ml), transfusion rate (11.3%), and intraoperative complications diminished with surgical experience and were less in the newer generations of surgeons ( p p Conclusions Experience gained by the first generation of surgeons helped newer surgeons reduce the duration and morbidity of their corresponding learning curves.

[1]  Konstantinos Skriapas,et al.  Laparoscopic radical prostatectomy: the value of intraoperative frozen sections. , 2005, European urology.

[2]  H. Klingler,et al.  Morbidity of laparoscopic extraperitoneal versus transperitoneal radical prostatectomy verus open retropubic radical prostatectomy. , 2005, European urology.

[3]  Li-Ming Su,et al.  Laparoscopic and robotic assisted radical prostatectomy--critical analysis of the results. , 2006, European urology.

[4]  H. Pérez-Chrzanowska,et al.  Handling Complications in Laparoscopic Radical Prostatectomy , 2005 .

[5]  Jens-Uwe Stolzenburg,et al.  Modular surgical training for endoscopic extraperitoneal radical prostatectomy , 2005, BJU international.

[6]  B. Guillonneau,et al.  Perioperative complications of laparoscopic radical prostatectomy: the Montsouris 3-year experience. , 2002, The Journal of urology.

[7]  D. Teber,et al.  Comparison of training modalities for performing laparoscopic radical prostatectomy: experience with 1,000 patients. , 2005, Journal of Urology.

[8]  P. Schellhammer,et al.  Laparoscopic radical prostatectomy: decreasing the learning curve using a mentor initiated approach. , 2003, The Journal of urology.

[9]  C. Schulman,et al.  Laparoscopic radical prostatectomy: the learning curve , 2005, Current opinion in urology.

[10]  D. Teber,et al.  Laparoscopic radical prostatectomy with the Heilbronn technique: oncological results in the first 500 patients. , 2005, The Journal of urology.

[11]  J. Rassweiler,et al.  Heilbronn Laparoscopic Radical Prostatectomy , 2001, European Urology.

[12]  J. Rassweiler,et al.  Laparoscopic radical prostatectomy: prospective evaluation of the learning curve. , 2005, European urology.

[13]  Inderbir S. Gill,et al.  Laparoscopic Urologic Surgery in Malignancies , 2005 .

[14]  Matteo Riva,et al.  Intra- and peri-operative outcomes comparing radical retropubic and laparoscopic radical prostatectomy: results from a prospective, randomised, single-surgeon study. , 2006, European urology.

[15]  C. Abbou,et al.  Laparoscopic radical prostatectomy: Published series , 2002, Current urology reports.

[16]  S. Barmoshe,et al.  Nerve sparing laparoscopic radical prostatectomy: our technique. , 2006, European urology.

[17]  S. Loening,et al.  Positive margins after laparoscopic radical prostatectomy: a prospective study of 100 cases performed by 4 different surgeons. , 2003, European urology.

[18]  R. Rabenalt,et al.  Endoscopic extraperitoneal radical prostatectomy: oncological and functional results after 700 procedures. , 2005, The Journal of urology.

[19]  C. Abbou,et al.  Laparoscopic Radical Prostatectomy , 2001, European Urology.

[20]  G Vallancien,et al.  Laparoscopic radical prostatectomy: oncological evaluation after 1,000 cases a Montsouris Institute. , 2003, The Journal of urology.

[21]  S. Değer,et al.  Laparoscopic radical prostatectomy--the experience of the German Laparoscopic Working Group. , 2006, European urology.

[22]  B. Guillonneau,et al.  Laparoscopic radical prostatectomy: a critical analysis of surgical quality. , 2006, European urology.

[23]  B. Guillonneau,et al.  Laparoscopic radical prostatectomy. , 2002, The Journal of urology.