title: Evaluation of complications in endoscopic extraperitoneal radical prostatectomy in a modular training programme: a multicentre experience.
abstract: OBJECTIVE
  Structured mentor-based "modular surgical training (MST)" has proved to be an effective way to teach endoscopic extraperitoneal radical prostatectomy (EERPE) safely to residents, even those without previous experience in laparoscopic surgery. We report on complications in early patient series from two centres where EERPE was established by MST held at the same teaching centre.
  
  
  METHODS
  Three trainees from two departments underwent MST at the same teaching centre. Thereafter, they were supervised by their mentor at their hospital. Peri-operative and post-operative complications of the first 245 (centre 1) and 288 (centre 2) cases were analysed retrospectively by the revised Clavien classification and compared to a large series (n = 1300) from the teaching centre. P < 0.05 were considered significant.
  
  
  RESULTS
  In total, 427 (80.1%) patients were without complications at the training centres. Intra-operative complications occurred in 8 (1.6%) patients. Among 98 (18.3%) patients with post-operative complications, 41 (7.7%) and 7 (1.3%) patients with Clavien grade I and II complications required no or pharmacological treatment, respectively. Totally, 40 (7.5%) patients required surgical intervention (Clavien grade III). Grade IV and V complications were observed in 9 (1.7%) and 1 (0.2%) cases, respectively. A comparison of complications from the training centres and the teaching centre revealed no statistically significant difference.
  
  
  CONCLUSIONS
  Novice laparoscopic surgeons can safely learn EERPE by a structured, mentor based, modular surgical training programme without putting patients at risk. The complication rates in early patient series are low and comparable to those of the teaching centre.
authors.affiliation: Department of Urology, University of Regensburg, Krankenhaus St. Josef, Landshuter Strasse 65, 93053, Regensburg, Germany. roman.ganzer@gmx.de
authors.forename: Roman
authors.initials: R
authors.lastname: Ganzer
authors.forename: Robert
authors.initials: R
authors.lastname: Rabenalt
authors.forename: Michael C
authors.initials: MC
authors.lastname: Truss
authors.forename: Stefanos
authors.initials: S
authors.lastname: Papadoukakis
authors.forename: Minh
authors.initials: M
authors.lastname: Do
authors.forename: Andreas
authors.initials: A
authors.lastname: Blana
authors.forename: Markus
authors.initials: M
authors.lastname: Straub
authors.forename: Stefan
authors.initials: S
authors.lastname: Denzinger
authors.forename: Wolf F
authors.initials: WF
authors.lastname: Wieland
authors.forename: Martin
authors.initials: M
authors.lastname: Burchardt
authors.forename: Thomas
authors.initials: T
authors.lastname: Herrmann
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Stolzenburg
mesh_terms: D000328:Adult; D000368:Aged; D004503:Education, Medical, Graduate / Q000379:methods; D005500:Follow-Up Studies; D013502:General Surgery / Q000193:education*; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D010535:Laparoscopy; D008297:Male; D008611:Mentors; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology / Q000517:prevention & control; D011468:Prostatectomy / Q000009:adverse effects* / Q000193:education*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors