Assessing the predictive validity and efficacy of a multimodal training programme for laparoscopic radical prostatectomy (LRP).
OBJECTIVE
To assess the predictive validity (ability to correlate to real-life environment) and efficacy of a training programme for laparoscopic radical prostatectomy (LRP), based on a structured and progressive pelvitrainer component with hands-on clinical training in the operating room (OR).


METHODS
Prospective data on 500 LRP cases were analysed with 80 excluded due to incomplete records. The operation was divided into multiple steps. Times for these steps were compared among 11 surgeons with different laparoscopic expertise (first-, second-, and third-generation surgeons in order of decreasing experience) and correlated to times for specific exercises on the pelvitrainer that simulated particular steps. Perioperative parameters were also evaluated among the three groups.


RESULTS
Pelvitrainer times achieved by trainees (third-generation surgeons) did not differ significantly with times for corresponding steps of LRP. There was also no significant difference for total OR time between the second- and third-generation surgeons (205 and 207 min, respectively; p>0.05) although the time for the first-generation surgeons was faster than both (176 min). Short-term quality indicators for first, second, and third generations included transfusion rates (2.3%, 2.4%, and 2.6%, respectively), positive margin rates (20.3%, 21.5%, and 23.0%) and complications, which did not differ significantly among the generations although the first-generation surgeons had the lowest rates.


CONCLUSIONS
A carefully designed training programme that incorporates both pelvitrainer and mentor-based operative training is essential for the effective and safe transfer of skills and knowledge required to learn LRP.
Sugiono
Marto
M
Department of Urology, SLK-Klinikum Heilbronn, University of Heidelberg, Am Gesundbrunnen 20, D-77074 Heidelberg, Germany.
Teber
Dogu
D
Anghel
Gabriel
G
Gözen
Ali Serdar
AS
Stock
Christian
C
Hruza
Marcel
M
Frede
Thomas
T
Klein
Jan
J
Rassweiler
Jens J
JJ
D000328:Adult; D000368:Aged; D002983:Clinical Competence; D004502:Education, Medical, Continuing; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects / Q000193:education*; D013664:Teaching Materials; D014572:Urology / Q000193:education*