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Related Experiment Videos

Robotic prostatectomy: the first UK experience.

E K Mayer1, M H Winkler, R Aggarwal

  • 1Imperial Robotic Urological Surgery Group, Department of Urology, St Mary's Hospital, London, UK.

The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS
|May 24, 2007
PubMed
Summary
This summary is machine-generated.

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This study introduces a teamwork approach for robot-assisted radical prostatectomy training. The structured program allowed multiple surgeons to safely learn the procedure, achieving comparable learning curve parameters to other centers.

Area of Science:

  • Urology
  • Surgical Technology
  • Robotics in Medicine

Background:

  • Establishing the UK's first clinical program for robotically assisted laparoscopic radical prostatectomy required a novel approach.
  • The Imperial Robotic Urological Surgery Group initiated their program on November 22, 2004.

Purpose of the Study:

  • To describe a teamwork strategy for setting up a new robotic surgery program.
  • To evaluate the learning curve and safety of robotically assisted radical prostatectomy using a structured team approach.

Main Methods:

  • A team of four consultant urological surgeons utilized a structured, rotating system based on eight defined surgical stages.
  • Surgeons rotated between console time and tableside assistance, with a focus on maintaining surgical fluidity.
  • Prospective data collection for the first 50 cases allowed for comparison of learning curve parameters.

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Main Results:

  • Median operative time was 369.5 minutes with a median blood loss of 700 ml; 12% of patients required transfusion.
  • Four cases (8%) were converted to open surgery, and complications included four anastomotic leaks and two rectal injuries.
  • Median hospital stay was 4 days, with a 22% positive surgical margin rate.

Conclusions:

  • The learning curve parameters for this team-based approach are comparable to initial series reported by other robotic centers.
  • Teamwork facilitated safe and efficient simultaneous training for four surgeons in robotically assisted radical prostatectomy.
  • The structured program demonstrated that urological surgeons with varying laparoscopic experience can competently perform this procedure.