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Related Experiment Video

Updated: Aug 6, 2025

Retzius-Sparing Robot-Assisted Radical Prostatectomy
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LAPAROSCOPIC RADICAL PROSTATECTOMY: SINGLE CENTER CASE SERIES.

Luka Penezić1,2, Tomislav Kuliš1,2, Tvrtko Hudolin1,2

  • 1Department of Urology, University Hospital Center Zagreb.

Acta Clinica Croatica
|March 20, 2023
PubMed
Summary

This study shows that laparoscopic radical prostatectomy (LRP) can be safely learned and performed with good outcomes, even by surgeons new to the procedure. Initial learning curve and clinical results were favorable.

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Area of Science:

  • Urology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Laparoscopic radical prostatectomy (LRP) is a complex surgical procedure with a historically steep learning curve.
  • Despite challenges, LRP is increasingly adopted globally for prostate cancer treatment.

Purpose of the Study:

  • To evaluate the initial learning curve and clinical outcomes of LRP performed by novice surgeons at a single center.
  • To assess the feasibility and safety of mastering LRP through a structured learning approach.

Main Methods:

  • Retrospective analysis of 63 LRP cases performed over 22 months by two surgeons with no prior LRP experience.
  • Patient selection based on low-to-intermediate risk prostate cancer according to European Association of Urology guidelines.
  • Outcomes assessed included operative time, blood loss, complications (Clavien-Dindo), positive surgical margins, PSA recurrence, and urinary continence.
Keywords:
Case seriesLaparoscopyLearning curveRadical prostatectomy

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Main Results:

  • Median follow-up was 19.6 months.
  • Median operative time decreased significantly from early to late cases, as did median estimated blood loss (196.8 min, 257.1 mL).
  • High rates of undetectable PSA (93.6%) and urinary continence (87.3%) were achieved, with low complication rates (7.9% Clavien-Dindo grade II).

Conclusions:

  • A methodical learning approach enables safe acquisition of LRP skills by surgeons new to the technique.
  • Favorable clinical outcomes, including oncological control and functional recovery, can be achieved during the initial learning phase of LRP.
  • LRP is a viable and effective treatment option for selected prostate cancer patients when performed by surgeons progressing through a structured learning curve.