Learning curve for robot-assisted laparoscopic partial nephrectomy
Xie Yongpeng, Ma Xin, Li Hongzhao, Wang Baojun, Shi Taoping, Zhang Yu, Ai Qing, Huang Qingbo, Fan Yang, Gao Yu, Li Xintao, Chen Luyao, Ming Shaoxiong, Zhang Xu
Department of Urology, General Hospital of PLA, Beijing 100853, China
Abstract：Objective: To discuss the learning curve of Robot-assisted laparoscopic partial nephrectomy(PALPN). Methods: We compared the perioperative outcomes of the first 20 patients who underwent RALPN to the latest 20 patients who underwent LPN performed by the same surgeons. All surgical operations ere done Between May 2013 and August 2013. The surgeons had completed more than 1 000 cases of LPN and more than 300 cases of robot-assisted laparoscopic radical prostatectomy. The learning curve was defined as the number of cases required to proficiently perform RALNP with shorter average operative time (OT) and warm ischemia times (WIT) , as compared to the latest 20 patients subject to LPN. Results: The two groups had comparable preoperative demographics and tumor histopathology. No patients in either group had a positive surgical margin. There was a downward trend in both OT and WIT during the RALPN learning curve. After RALPN for the first 9 cases, the average OT reached that of the last 20 cases subject to LPN. The average OT and WIT of the first 9 cases subject to RALPN werepatients 134 min and 20 min,compared with those of 107 min and 14 min of the last 11 cases subject to RALPN. Conclusions: The transiion from LPN to RALNP is rapid in an experienced laparoscopic surgeon. There were no significant differences in WIT, blood loss,or length of hospital stay between LPN and RALPN. RALPN achieved a similar OT as LPN after 9 procedures.
