title: Key areas in the learning curve for robotic urological surgery: a Spanish multicentre survey.
abstract: BACKGROUND
  The number of robotic-assisted procedures offered in Spain is rapidly increasing despite a lack of consensus criteria for training and credentialling.
  
  
  OBJECTIVE
  This national multicentre study was designed to analyze the different areas of the robotic urological surgery learning curve.
  
  
  METHODS
  A questionnaire was sent to all 13 urology units in Spain with an active robotics programme requesting information on training and problems encountered.
  
  
  RESULTS
  In most centres (n = 11, 84.6%), training programmes were animal-based; cadavers were used at only 2 (15.4%). Proctoring in initial procedures was practiced by 12 groups (92.3%). When initiating the robotics programme, the console was shared at 8 units (61.5%). Prior experience in open and/or laparoscopic surgery was reported by 10 of the groups (76.9%), and experience in open surgery only by 2 (15.4%) or robotic surgery alone by 1 (7.7%). The procedure with which the robotics programme was started in all 13 participating units was radical prostatectomy. The number of cases needed to complete the learning curve for this procedure was 20-25 cases according to 8 (61.5%) surgery teams.
  
  
  CONCLUSIONS
  Up until March 26, 2010, 1,692 operations, mostly radical prostatectomies, were conducted using the da Vinci robot in our country.
authors.affiliation: Urology Department, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain. dr_jmoreno @ hotmail.com
authors.forename: Jesús
authors.initials: J
authors.lastname: Moreno Sierra
authors.forename: Cristina
authors.initials: C
authors.lastname: Fernández Pérez
authors.forename: Elena
authors.initials: E
authors.lastname: Ortiz Oshiro
authors.forename: Angel
authors.initials: A
authors.lastname: Silmi Moyano
authors.forename: Humberto
authors.initials: H
authors.lastname: Villavicencio Mavrich
authors.forename: Jose Gregorio
authors.initials: JG
authors.lastname: Pereira Arias
authors.forename: Antonio
authors.initials: A
authors.lastname: Allona Almagro
authors.forename: Miguel
authors.initials: M
authors.lastname: Unda Urzaiz
authors.forename: Jesús
authors.initials: J
authors.lastname: Padilla Nieva
authors.forename: Ion
authors.initials: I
authors.lastname: Madina Albisua
authors.forename: Javier
authors.initials: J
authors.lastname: Estebanez Zarranz
authors.forename: Rafael
authors.initials: R
authors.lastname: Medina López
authors.forename: Victor
authors.initials: V
authors.lastname: Baena Gonzalez
authors.forename: Eladio
authors.initials: E
authors.lastname: Franco Miranda
authors.forename: Juan
authors.initials: J
authors.lastname: Morote Robles
authors.forename: Juan Jose
authors.initials: JJ
authors.lastname: Gomez Ruiz
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate; D019538:Health Care Surveys; D006801:Humans; D059032:Learning Curve; D016730:Program Development; D015397:Program Evaluation; D012371:Robotics / Q000193:education*; D013030:Spain; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000193:education*; D011795:Surveys and Questionnaires; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000193:education*