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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Retzius-Sparing Robot-Assisted Radical Prostatectomy
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Development and Validation of an Objective Scoring Tool for Robot-Assisted Partial Nephrectomy: Scoring for Partial

Umar Iqbal1, Zhe Jing1, Youssef Ahmed1

  • 1A.T.L.A.S. (Applied Technology Laboratory for Advanced Surgery), Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.

Journal of Endourology
|November 23, 2021
PubMed
Summary

A new tool, Scoring for Partial Nephrectomy (SPaN), objectively assesses robot-assisted partial nephrectomy (RAPN) skills. This reliable, procedure-specific instrument aids in evaluating surgeon proficiency during RAPN.

Keywords:
assessmentpartial nephrectomyrobot-assistedscoring toolsurgical training

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Area of Science:

  • Urology
  • Surgical Technology
  • Medical Education

Background:

  • Robot-assisted partial nephrectomy (RAPN) requires standardized assessment tools.
  • Existing methods may lack objectivity and specificity for RAPN.

Purpose of the Study:

  • To develop and validate the Scoring for Partial Nephrectomy (SPaN), a structured tool for assessing RAPN technical proficiency.

Main Methods:

  • A multi-institutional panel of 10 expert robotic surgeons deconstructed RAPN into 6 domains.
  • Delphi methodology and content validity index (CVI) were used for content validation.
  • Inter-rater reliability and construct validity were assessed using video analysis and statistical measures.

Main Results:

  • The final SPaN tool comprises 6 domains, achieving expert consensus (CVI ≥0.75) after two rounds.
  • High inter-rater reliability (>0.75) was demonstrated across all domains.
  • No significant difference in median scores was found between attending surgeons and trainees.

Conclusions:

  • SPaN is a structured, reliable, and procedure-specific tool for objectively assessing RAPN technical proficiency.
  • While construct validity requires further investigation, SPaN offers a valuable method for surgical skill evaluation in RAPN.