title: Learning curve of robotic-assisted radical prostatectomy with 60 initial cases by a single surgeon.
abstract: OBJECTIVE
  We tracked various proficiency indicators for the learning curve as a single Taiwanese surgeon became familiar with robotic-assisted laparoscopic radical prostatectomy surgeries by performing 60 initial procedures.
  
  
  METHODS
  Between December 2005 and December 2007, 60 consecutive patients were classified into Group 1 (Cases 1-30) or Group 2 (Cases 31-60). Pre-operative clinical characteristics, operative parameters, and postoperative parameters were assessed.
  
  
  RESULTS
  Pre-operative biopsy Gleason scores were significantly higher in Group 2 than in Group 1 (7.03 vs. 6.13, P < 0.01). The vesicourethral anastomosis time showed a statistically significant reduction from 46.38 minutes in Group 1 to 31 minutes in Group 2 (p < 0.01). The continence rate at 3 months in Group 2 was higher than that in Group 1 (97.6%vs. 76.7%, p = 0.052); the mean duration to continence was shorter in Group 2 than Group 1 (70.26 ± 67.37 days vs. 39.63 ± 36.48 days, p = 0.056). Group 2 had shorter postoperative stays (3.93 vs. 7.33) and longer durations of Foley catheter removal (9.0 vs. 7.7) than Group 1, representing a statistically significant difference (p < 0.01).
  
  
  CONCLUSIONS
  After gaining experience by performing an initial 30 robotic-assisted laparoscopic radical prostatectomies, the subsequent 30 surgeries established proficiency as determined by vesicourethral anastomosis time and early continence rate.
authors: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan. ycou@vghtc.gov.tw
authors: Yen-Chuan
authors: YC
authors: Ou
authors: Chi-Rei
authors: CR
authors: Yang
authors: John
authors: J
authors: Wang
authors: Chen-Li
authors: CL
authors: Cheng
authors: Vipul R
authors: VR
authors: Patel
mesh_terms: D000368:Aged; D002983:Clinical Competence; D006801:Humans; D010535:Laparoscopy; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000193:education* / Q000379:methods; D011471:Prostatic Neoplasms / Q000601:surgery*; D020127:Recovery of Function; D012371:Robotics; D016896:Treatment Outcome