Evaluation of complications in endoscopic extraperitoneal radical prostatectomy in a modular training programme: a multicentre experience.
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.
Ganzer
Roman
R
Department of Urology, University of Regensburg, Krankenhaus St. Josef, Landshuter Strasse 65, 93053, Regensburg, Germany. roman.ganzer@gmx.de
Rabenalt
Robert
R
Truss
Michael C
MC
Papadoukakis
Stefanos
S
Do
Minh
M
Blana
Andreas
A
Straub
Markus
M
Denzinger
Stefan
S
Wieland
Wolf F
WF
Burchardt
Martin
M
Herrmann
Thomas
T
Stolzenburg
Jens-Uwe
JU
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