title: Does previous robot-assisted radical prostatectomy experience affect outcomes at robot-assisted radical cystectomy? Results from the International Robotic Cystectomy Consortium.
abstract: OBJECTIVE
  To evaluate the effect of previous robot-assisted radical prostatectomy (RARP) case volume on the outcomes of robot-assisted radical cystectomy. Little is known regarding the effect of previous robotic surgical experience on the implementation and execution of robot-assisted radical cystectomy.
  
  
  METHODS
  Using the International Robotic Cystectomy Consortium database, 496 patients were identified who had undergone robot-assisted radical cystectomy by 21 surgeons at 14 institutions from 2003 to 2009. The surgeons were divided into 4 groups according to their previous RARP experience (≤ 50, 51-100, 101-150, and > 150 cases). The overall operative time, blood loss, lymph node yield, pathologic stage, and surgical margin status were compared among the 4 groups using chi-square analysis.
  
  
  RESULTS
  The mean operative time was 386 minutes (range 178-827). The mean estimated blood loss was 408 mL (range 25-3500). The operative time and blood loss were both significantly associated with previous RARP experience (P < .001). The mean lymph node count was 17.8 nodes (range 0-68). Lymph node yield and increased pathologic stage were significantly associated with previous RARP experience (P < .001). Finally, 34 (7.0%) of the 482 patients had a positive surgical margin. Margin status was not significantly associated with previous RARP experience (P = .089).
  
  
  CONCLUSIONS
  Previous RARP case volume might affect the operative time, blood loss, and lymph node yield at robot-assisted radical cystectomy. In addition, surgeons with increased RARP experience operated on patients with more advanced tumors. Previous RARP experience, however, did not appear to affect the surgical margin status.
authors: Department of Urologic Oncology, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.
authors: Matthew H
authors: MH
authors: Hayn
authors: Nicholas J
authors: NJ
authors: Hellenthal
authors: Abid
authors: A
authors: Hussain
authors: Paul E
authors: PE
authors: Andrews
authors: Paul
authors: P
authors: Carpentier
authors: Erik
authors: E
authors: Castle
authors: Prokar
authors: P
authors: Dasgupta
authors: Rodney
authors: R
authors: Davis
authors: Raju
authors: R
authors: Thomas
authors: Shamim
authors: S
authors: Khan
authors: Adam
authors: A
authors: Kibel
authors: Hyung
authors: H
authors: Kim
authors: Murugesan
authors: M
authors: Manoharan
authors: Mani
authors: M
authors: Menon
authors: Alex
authors: A
authors: Mottrie
authors: David
authors: D
authors: Ornstein
authors: James
authors: J
authors: Peabody
authors: Raj
authors: R
authors: Pruthi
authors: Joan
authors: J
authors: Palou Redorta
authors: Manish
authors: M
authors: Vira
authors: Francis
authors: F
authors: Schanne
authors: Hans
authors: H
authors: Stricker
authors: Peter
authors: P
authors: Wiklund
authors: Greg
authors: G
authors: Wilding
authors: Khurshid A
authors: KA
authors: Guru
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D002983:Clinical Competence; D015653:Cystectomy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D012371:Robotics; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*