Cristina Falavolti1*, Federico Sergi2, Tommasangelo Petitti3, Vincenzo Pagliarulo4 and Maurizio Buscarini1
1Department of Urology, Campus Biomedico University, Italy
2Department of Urology and Kidney Transplant, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Italy
3Hygiene and Public Health Researcher, Campus Biomedico University, Italy
4Department of Urology, University of Bari, Italy
Objective: To investigate the impact that surgeon and operative room team experience rule in operative time and surgical outcomes.Material and
Methods: We retrospectively collected data of 150 robotic radical prostatectomy (RALPs) performed by the same surgeon in two different hospitals in different periods of his robotic experience. The first and the last 50 RALPs performed in a dedicated center of robotic surgery at University of Southern California were included respectively in group 1 and group 2. The first 50 RALPs performed at University Campus Bio-Medico of Rome were included in group 3. In this case, both first assistant and nursing team were at the beginning of their robotic experience. Monovariate analysis was performed comparing each group in terms of oncological and surgical outcomes. Multivariate logistic regression models were used to assess the risk of positive margin.Results: The mean docking time in group 2 and 3 decreases significantly compared to group 1. In group 3 the operative time is significant longer. The mean estimated blood loss is higher in group 1 and the number of transfusions decreases in group 2 and 3. The probability to have surgical positive margins increases from pT2a-b-c to pT3b tumor stage. The study is limited because of its retrospective form.Conclusion: Surgeon, assistant, and nurses have a cardinal role in operative and surgical outcomes. Tumor stage is the principle parameter that influences the oncological outcome. About 50 procedures are required to reach satisfactory operative outcomes although the learning curve continues for hundreds procedures.
Cristina F, Sergi F, Petitti T, Maurizio B, Pagliarulo V. Same Operation, Same Robot, Different Countries: Does it make a Difference? Clin Surg. 2016; 1: 1087.