Live surgery: highly educational or harmful?

Area of Science:

• Urologic Surgery
• Surgical Education
• Patient Safety

Background:

• Live surgery (LS) is a valuable educational tool in urology.
• Balancing teaching benefits with patient safety is crucial.
• The Congress Challenge in Laparoscopy and Robotics (CILR) provides a platform for expert-led live surgical events.

Purpose of the Study:

• To evaluate the complication rate of urologic live surgeries performed by experts.
• To assess patient safety during live surgical events within the CILR framework.
• To analyze postoperative morbidity using the Postoperative Morbidity Index (PMI).

Main Methods:

• A retrospective analysis of a multi-institution, multi-surgeon database from 12 CILR events (2004-2015).
• Inclusion of 224 urologic cases, with radical prostatectomy (RP) being the most frequent procedure.
• Primary endpoint was postoperative complications, quantified using the Postoperative Morbidity Index (PMI).

Main Results:

• A total of 224 cases were analyzed, with a gradual increase in case volume over the years.
• The overall complication rate was 11.6% (26 out of 224 cases), with varying severity grades.
• Postoperative Morbidity Index (PMI) was significantly higher for cystectomy compared to radical prostatectomy (RP).

Conclusions:

• Live surgery (LS) in the CILR setting demonstrates a low overall complication rate, even for complex urologic procedures.
• Radical prostatectomy (RP) appears to be a particularly safe procedure in the context of live surgery.
• The Postoperative Morbidity Index (PMI) did not correlate with increased complexity in this series.