Robot-assisted laparoscopic radical prostatectomy using modular training programme in a private hospital.

Area of Science:

• Urology
• Surgical Education
• Robotic Surgery

Background:

• Robotic-assisted laparoscopic radical prostatectomy (RALRP) is a complex procedure.
• Effective fellowship training models are crucial for surgeon competency.
• Balancing patient safety, training, and efficiency in private hospital settings presents unique challenges.

Purpose of the Study:

• To evaluate a novel 13-step modular robotic fellowship training program for radical prostatectomy.
• To assess the impact of this program on patient safety, surgical outcomes, and training efficiency.
• To demonstrate the feasibility of implementing such a program in a private hospital.

Main Methods:

• A prospective study involving 64 patients undergoing RALRP using a 13-step modular training program.
• Comparison with a control group of 64 patients operated on by a mentoring surgeon prior to the program.
• Analysis of key metrics: console time, total operating time, blood loss, positive surgical margin rate, and postoperative complications.

Main Results:

• No statistically significant difference in total operating time, blood loss, or positive surgical margin rates between the groups.
• A marginal difference in mean console time (p=0.02) was observed, but overall efficiency was maintained.
• Trainees successfully completed modular training steps while maintaining surgical momentum.

Conclusions:

• A comprehensive modular training program for robotic radical prostatectomy can be successfully implemented in a private hospital.
• This model effectively balances patient safety, surgical time efficiency, and adequate surgeon training.
• The findings support the adoption of structured, modular fellowship programs for complex robotic procedures.