A Safe teaching protocol of LRP (laparoscopic radical prostatectomy)

Area of Science:

• Urology
• Surgical Education
• Minimally Invasive Surgery

Background:

• Laparoscopic radical prostatectomy (LRP) presents a significant learning curve, potentially impacting patient safety.
• Developing effective training protocols is crucial for surgical proficiency in LRP.

Purpose of the Study:

• To present an adapted modular training system designed to optimize the learning curve for LRP.
• To enhance patient safety during the surgical training process for LRP.

Main Methods:

• A retrospective analysis of an LRP safe learning protocol implemented over eight years (2008-2015) in a fellowship program.
• The protocol divided LRP into 12 steps and 5 difficulty levels with time constraints for fellows.
• Fellows' surgeries were compared to a prior series performed by experienced tutors.

Main Results:

• 250 LRP procedures were performed by fellows during the program, with 150 post-completion.
• Fellows had longer operative times (150 min) compared to tutors, but similar blood loss.
• No conversions to open surgery were noted; however, tutors achieved better functional and oncological outcomes.

Conclusions:

• The LRP safe learning protocol effectively optimizes the learning curve and facilitates safe surgical practice.
• Achieving optimal functional and oncological outcomes in LRP requires more than 25 cases, highlighting the procedure's complexity.